Individual
CHRISTINE MAYWORM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DTH, PSYCHOLOGY
Contact information
Practice address
150 BLUEBERRY RD, LIBERTYVILLE, IL 60048-2167
(847) 816-0013
(847) 680-3311
Mailing address
150 BLUEBERRY RD, LIBERTYVILLE, IL 60048-2167
(847) 816-0013
(847) 680-3311
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
IL
222Q00000X
Developmental Therapist
Primary
CM08170993P
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM08170993P
EARLY INTERVENTION NUMBER
IL
Enumeration date
05/23/2007
Last updated
09/11/2025
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