Individual
MR. DESMOND PAUL RAFTERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
787 PENRITH AVE, ELK GROVE VILLAGE, IL 60007-3612
(630) 415-3638
Mailing address
787 PENRITH AVE, ELK GROVE VILLAGE, IL 60007-3612
(630) 415-3638
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.008719
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1626558
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/01/2006
Last updated
07/08/2007
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