Individual
MICAH SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Credential
MSW
Contact information
Practice address
676 N SAINT CLAIR ST FL 11, CHICAGO, IL 60611-2954
(312) 694-0882
Mailing address
676 N SAINT CLAIR ST FL 11, CHICAGO, IL 60611-2954
(312) 694-0882
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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