Individual
DR. CONSTANCE ANITA FULLILOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
205 W RANDOLPH ST STE 830, CHICAGO, IL 60606-1815
(312) 236-1498
Mailing address
205 W RANDOLPH ST STE 830, CHICAGO, IL 60606-1815
(312) 236-1498
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-002239
IL
Other
Enumeration date
11/08/2006
Last updated
04/23/2021
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