Individual
MARY MADRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
3301 W 111TH ST, CHICAGO, IL 60655-2715
(312) 469-0486
(773) 233-6111
Mailing address
317 W CALENDAR AVE APT 3B, LA GRANGE, IL 60525-2029
(252) 671-0238
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010572
IL
Other
Enumeration date
07/10/2017
Last updated
10/05/2021
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