Individual
MR. MICAH K SWANSEY SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
593 BURNHAM AVENUE, CALUMET CITY, IL 60409
(708) 832-1002
(708) 832-1099
Mailing address
2490 GLEN EAGLES DR, OLYMPIA FIELDS, IL 60461-1160
(708) 259-8154
(708) 747-1038
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006944
IL
Other
Enumeration date
03/20/2007
Last updated
09/19/2017
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