Individual
MS. CAROL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
2311 E 98TH ST, CHICAGO, IL 60617-4842
(773) 785-4955
(773) 785-9011
Mailing address
222 S JEFFERSON ST, CHICAGO, IL 60661-5603
(312) 441-9009
(312) 441-9019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
26825
IL
Other
Enumeration date
04/05/2018
Last updated
04/05/2018
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