Individual
MR. MICHAEL FLOYD MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
4100 VETERANS PKWY, MCHENRY, IL 60050-8350
(815) 759-7032
(815) 759-7298
Mailing address
4655 N SPAULDING AVE APT 2, CHICAGO, IL 60625-6923
(630) 386-1613
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362480845
—
IL
Enumeration date
04/29/2013
Last updated
03/12/2022
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