Individual
NICOL J MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1032 SCHOOLGATE RD, NEW LENOX, IL 60451-2681
(708) 768-1590
(708) 768-1590
Mailing address
1032 SCHOOLGATE RD, NEW LENOX, IL 60451-2681
(708) 768-1590
(708) 768-1590
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.112599
IL
Other
Enumeration date
05/02/2025
Last updated
06/06/2025
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