Individual
CAROLINE COREY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP
Contact information
Practice address
2310 W ROOSEVELT RD, CHICAGO, IL 60608-1131
(312) 477-6766
Mailing address
2310 W ROOSEVELT RD, CHICAGO, IL 60608-1131
(312) 477-6766
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
T.2405899
OH
171M00000X
Case Manager/Care Coordinator
—
CA
Other
Enumeration date
02/21/2013
Last updated
01/02/2025
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