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General NPI Number Information
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NPI Number | 1760061113
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Entity Type | Individual
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Provider Name | ALLISON CETINA
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 1416 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60657-0939
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Country | US
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Telephone | 630-779-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 1336 N DAMEN AVE APT 104
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City | CHICAGO
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State | IL
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Zip | 60622-2298
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Country | US
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Telephone | 630-779-9222
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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 | 150.104990
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License Number State | IL
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