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Individual

MAXWELL WOLCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 RAVINIA PL, ORLAND PARK, IL 60462-3761
(301) 717-9173
Mailing address
2439 N MOZART ST, CHICAGO, IL 60647-2613
(301) 717-9173

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.102023
IL

Other

Enumeration date
09/25/2016
Last updated
09/25/2016
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