Individual
CHERYL WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 S SOUTH SHORE DR, CHICAGO, IL 60649-1310
(773) 955-9760
Mailing address
1448 E 52ND ST # 398, CHICAGO, IL 60615-4122
(773) 955-9760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178007636
IL
101YP2500X
Professional Counselor
178007636
IL
Other
Enumeration date
01/10/2018
Last updated
03/17/2018
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