Most Relevant Information
Provider Data
| NPI Number: | 1003325556 |
| Provider Name: | ELMO PAINTER |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/27/2017 |
| Last Updated: | 09/27/2017 |
Provider Practice Location
3525 W PETERSON AVE
CHICAGO
IL
606593324
Practice Location Phone/Fax
| Phone: | 7735468028 |
| Fax: | 7735468028 |
Provider Mailing Location
3525 W PETERSON AVE
CHICAGO
IL
606593324
Provider Mailing Phone/Fax
| Phone: | 7735468028 |
| Fax: |