Individual
GRACE AHN-IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1111 N WELLS ST, CHICAGO, IL 60610-7635
(312) 573-8860
Mailing address
1111 N WELLS ST STE 400, CHICAGO, IL 60610-7632
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010384
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2016
Last updated
02/18/2025
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