Organization
ADVANCED CLINICAL HEALTH SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDRENA JOY DAVIS LCSW (LICENSED CLINICAL SOCIAL WORKER)
(773) 879-2274
Entity
Organization
Contact information
Practice address
2925 S WABASH AVE STE 102, CHICAGO, IL 60616-3583
(773) 879-2274
(312) 225-6742
Mailing address
2925 S WABASH AVE STE 102, CHICAGO, IL 60616-3583
(773) 879-2274
(312) 225-6742
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149018258
IL
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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