Individual
DOMINIC M BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2930 W GRAND AVE, CHICAGO, IL 60622-4308
(872) 817-9858
Mailing address
2930 W GRAND AVE, CHICAGO, IL 60622-4308
(708) 603-8379
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.110200
IL
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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