Individual
MALISSA GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(847) 688-1900
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(847) 688-1900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010610
IL
Other
Enumeration date
10/20/2021
Last updated
12/27/2022
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