Shively-Mack, Suellen

Shively-Mack, Suellen is an individual health care provider with primary practice located at 240 Standish St , Elgin IL 60123-6421. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shively-Mack, Suellen can be contacted via phone (847) 742-5717.

Contact Information

Primary practice address
240 Standish St Elgin IL 60123-6421
Phone: (847) 742-5717
Fax: (847) 742-8154
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.010072 Illinois

Profile Details

NPI number 1205197415
LBN Legal business name Shively-Mack, Suellen
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2012
Last updated Jun 4th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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