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Individual

MR. ERIC CHRISTOPHER MALM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3401 N CENTRAL AVE, CHICAGO, IL 60634-4426
(773) 282-9845
(773) 282-9847
Mailing address
3401 N CENTRAL AVE, CHICAGO, IL 60634-4426
(773) 282-9845
(773) 282-9847

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
149011241
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1386961886
CHICAGO RESEARCH CENTER, INC.
IL
Enumeration date
05/12/2006
Last updated
04/27/2010
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