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Individual
MARK CHARLES MACDONALD
Active
Individual
MARK CHARLES MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-000701
IL
Other
Enumeration date
03/22/2007
Last updated
11/12/2013
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