Individual
CICELY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
77 W WASHINGTON ST, SUITE, CHICAGO, IL 60602-2801
(312) 823-8600
(312) 823-8600
Mailing address
1729 FOREST COVE DR APT 306, MOUNT PROSPECT, IL 60056-5488
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.012218
IL
Other
Enumeration date
06/14/2007
Last updated
12/30/2010
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