Individual
ELISE CARRIE BOLDEN-BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
3936 W ROOSEVELT RD, SUITE 2, CHICAGO, IL 60624-4389
(773) 826-0398
(773) 826-2327
Mailing address
3936 W ROOSEVELT RD, CHICAGO, IL 60624-4389
(773) 826-0398
(773) 826-2327
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
27812
IL
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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