Individual
ANGEL MACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4006 S WESTERN AVE, CHICAGO, IL 60609-2259
(773) 475-6375
Mailing address
4006 S WESTERN AVE, CHICAGO, IL 60609-2259
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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