Individual
MARY FARRELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5408 W DEVON AVE, CHICAGO, IL 60646-4106
(773) 594-0921
Mailing address
5408 W DEVON AVE, CHICAGO, IL 60646-4106
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
150.010895
IL
Other
Enumeration date
03/06/2015
Last updated
03/06/2015
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