Individual
DR. LUIS CARLOS MAYOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD.
Contact information
Practice address
1725 S NAPERVILLE RD, SUITE 206, WHEATON, IL 60189-5805
(630) 653-8409
(630) 653-8409
Mailing address
630 N FRANKLIN ST, UNIT 914, CHICAGO, IL 60654-8327
(248) 910-5381
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009209
IL
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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