Individual
MS. COURTNEY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1100 LAKE ST, SUITE 201, OAK PARK, IL 60301-1015
(773) 766-7010
Mailing address
6230 W CUYLER AVE, CHICAGO, IL 60634-1501
(773) 544-2714
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149008112
IL
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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