Individual
MADISSYN NICOLE FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W ADAMS ST STE 514, CHICAGO, IL 60606-5108
(312) 578-9990
Mailing address
300 W ADAMS ST STE 514, CHICAGO, IL 60606-5108
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.013341
IL
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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