Individual
UNICKA MARE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5651 S PERRY AVE, CHICAGO, IL 60621-4019
(414) 236-8489
Mailing address
5744 S ADA ST, CHICAGO, IL 60636-1832
(773) 960-3620
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
IL
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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