Individual
LILI-ANN GUSTAFSSON ELDEIRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
1140 N MCLEAN BLVD, SUITE 1, ELGIN, IL 60123-1782
(847) 695-3680
Mailing address
PO BOX 245, ALGONQUIN, IL 60102-0245
(847) 960-3635
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.014142
IL
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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