Individual
CHRISTINA MARIE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5710 N BROADWAY ST, CHICAGO, IL 60660-4302
(773) 728-1000
(773) 765-0401
Mailing address
5710 N BROADWAY ST, CHICAGO, IL 60660-4302
(773) 728-1000
(773) 765-0401
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149013156
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149013156
BLUE SHIELD
IL
Enumeration date
04/01/2009
Last updated
04/01/2009
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