Individual
MR. DANIEL POLIN WIMSATT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LCSW
Contact information
Practice address
2755 N PINE GROVE AVE, CHICAGO, IL 60614-6109
(773) 414-3565
Mailing address
2819 N CAMBRIDGE AVE, #3S, CHICAGO, IL 60657-6075
(773) 414-3565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149012429
IL
Other
Enumeration date
10/25/2006
Last updated
12/02/2010
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