Individual
DR. GRANT WHITE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
222 MERCHANDISE MART PLZ, SUITE 13-659 ROOM #1352, CHICAGO, IL 60654-1103
(708) 207-8074
(708) 679-0015
Mailing address
23002 AMBER LN, RICHTON PARK, IL 60471-1282
(708) 503-9880
(708) 679-0015
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-005123
IL
Other
Enumeration date
06/11/2012
Last updated
06/11/2012
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