Individual
DR. CAROLYN ANN MILDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1645 W GREGORY ST, CHICAGO, IL 60640-1161
(773) 444-9779
Mailing address
1645 W GREGORY ST, CHICAGO, IL 60640-1161
(773) 444-9779
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-35807
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/18/2007
Last updated
07/08/2007
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