Individual
GWENDOLYN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-0050
Mailing address
140 N ASHLAND AVE, CHICAGO, IL 60607-1802
(312) 850-0050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16255
IL
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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