Individual
MR. CARL L WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
858 N CLARK ST STE 203, CHICAGO, IL 60610-6804
(312) 298-9224
Mailing address
1344 RIDGELAND AVE, BERWYN, IL 60402-1143
(312) 934-4805
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.017598
IL
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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