Organization
CHANNELS 4 CHANGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRYSTAL YARNELL WILLIAMS LCSW (FOUNDER/CEO)
(773) 569-1180
Entity
Organization
Contact information
Practice address
6601 NORTH AVE, OAK PARK, IL 60302-1005
(773) 245-0010
Mailing address
1618 S 13TH AVE, MAYWOOD, IL 60153-1833
(773) 569-1180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149018421
IL
Other
Enumeration date
01/24/2017
Last updated
04/11/2017
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