Individual
LAURIN JARROLD MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
710 S PAULINA ST, SUITE 316A, CHICAGO, IL 60612-3808
(312) 563-2781
Mailing address
710 S PAULINA ST, SUITE 316A, CHICAGO, IL 60612-3808
(312) 563-2781
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071009099
IL
103TC0700X
Clinical Psychologist
Primary
071009099
IL
103TH0004X
Health Psychologist
—
IL
103TR0400X
Rehabilitation Psychologist
—
IL
Other
Enumeration date
05/12/2015
Last updated
04/06/2022
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