Suellen Shively-Mack, L.C.S.W

NPI 1205197415 · on the registry since 2012

Practice

Address: 240 Standish St
Elgin, IL 60123
Phone: (847) 742-5717
Fax: (847) 742-8154
Organisation at this address: Kairos Family Center, Inc.
Association For Individual Development
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-06-04

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois