Individual
CLINTON J MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10644 S FOREST AVE, CHICAGO, IL 60628-2845
(708) 864-1666
Mailing address
10644 S FOREST AVE, CHICAGO, IL 60628-2845
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IL
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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