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1000 Main St Apt 3h Evanston IL 60202-1770 | |
| (708) 734-5255 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1000 Main St Apt 3h, Evanston, Illinois |
| Authorized Official Name and Position | Iona Redmon (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 7088550783 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
20280 Governors Hwy Ste 206 Olympia Fields IL 60461-1068 Ph: (708) 734-5255 | 1000 Main St Apt 3h Evanston IL 60202-1770 Ph: (708) 734-5255 |
| NPI Number | 1871356964 |
|---|---|
| Provider Enumeration Date | 02/01/2024 |
| Last Update Date | 12/02/2024 |
| Certification Date | 12/02/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871356964 | NPI | - | NPPES |
| 356801206001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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