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Individual

TAYLOR MACAULAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1925 N CLYBOURN AVE, CHICAGO, IL 60614-4946
(773) 697-8839
Mailing address
1925 N CLYBOURN AVE STE 300, CHICAGO, IL 60614-7395

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000000000
SELF-PAY
Enumeration date
07/18/2022
Last updated
07/18/2022
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