Individual
SHELBY GRACE CUSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
311 W SUPERIOR ST STE 402, CHICAGO, IL 60654-3537
(312) 584-2144
(312) 971-8554
Mailing address
1438 W BELMONT AVE STE 1, CHICAGO, IL 60657-2166
(312) 508-3645
(312) 971-8554
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
05/16/2023
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