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Individual

MRS. CAROLYN CAMPBELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW,ACSW,BCD,LCSW

Contact information

Practice address
112 E CHESTNUT ST, CHICAGO, IL 60611-2014
(312) 787-2729
(312) 943-4459
Mailing address
684 W IRVING PARK RD APT E8, CHICAGO, IL 60613-3159
(773) 472-8725
(773) 472-1993

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02215636
BCBS PROVIDER NUMBER
IL
Enumeration date
03/16/2007
Last updated
07/08/2007
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