Individual
CANDICE BLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(262) 957-7281
Mailing address
4740 N CLARK ST, CHICAGO, IL 60640-4689
(773) 769-0205
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180015380
IL
Other
Enumeration date
10/11/2023
Last updated
10/18/2023
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