Individual
CHACE THOMAS GABRIELSON WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8 S MICHIGAN AVE FL 7, CHICAGO, IL 60603-3357
(312) 897-1420
Mailing address
2215 S ALBANY AVE # 2F, CHICAGO, IL 60623-3483
(773) 988-1269
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.020258
IL
Other
Enumeration date
04/06/2023
Last updated
08/01/2024
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