Individual
BYRON DALE HIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
(217) 714-7042
Mailing address
411 E PARK ST STE 106, CHAMPAIGN, IL 61820-3862
(217) 714-7042
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.117926
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/26/2024
Last updated
08/29/2025
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