| NPI | 1316149107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CHARLES MACDONALD Owner Of Private Practice 630-462-8810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149-000701) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180-005693) |
| 101YP2500X Counselor, Professional (Licence: IL 180-001600) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149-003332) | |
| 1041C0700X Social Worker, Clinical (Licence: IL 149-004725) | |
| 101YP2500X Counselor, Professional (Licence: IL 180-006320) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2013-11-12 |