Individual
SAMUEL PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2259 W TAYLOR ST, CHICAGO, IL 60612-4233
(312) 478-4567
Mailing address
230 E OHIO ST # 4101423, CHICAGO, IL 60611-3265
(888) 708-5561
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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