Individual
CARRIE BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4980 N MARINE DR, UNIT 831, CHICAGO, IL 60640-3969
(312) 730-7733
Mailing address
4980 N. MARINE DRIVE, UNIT 831, CHICAGO, IL 60640
(312) 730-7733
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.013423
IL
Other
Enumeration date
10/24/2013
Last updated
10/24/2013
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