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General NPI Number Information
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NPI Number | 1326743170
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Entity Type | Individual
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Provider Name | CINDY ANN KORSO LSW
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Gender | Female
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 1957 GRANDVIEW PL
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City | MONTGOMERY
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State | IL
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Zip | 60538-3035
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Country | US
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Telephone | 773-517-3744
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Fax |
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Provider Business Mailing Address
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Address Line | 4320 WINFIELD RD STE 200
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City | WARRENVILLE
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State | IL
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Zip | 60555-4023
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Country | US
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Telephone | 331-684-7140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 150108529
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License Number State | IL
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