Individual
MRS. CARRIE ELLEN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-1354
Mailing address
413 W CLARENDON ST, PROSPECT HEIGHTS, IL 60070-1403
(847) 394-3961
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006745-123
WI
Other
Enumeration date
06/30/2006
Last updated
07/09/2007
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