Most Relevant Information
Provider Data
| NPI Number: | 1003697467 |
| Provider Name: | CANDICE BLOCK |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 180015380 |
Most Important Dates
| Enumeration Date: | 10/11/2023 |
| Last Updated: | 10/18/2023 |
Provider Practice Location
4740 N CLARK ST
CHICAGO
IL
606404689
Practice Location Phone/Fax
| Phone: | 2629577281 |
| Fax: |
Provider Mailing Location
4740 N CLARK ST
CHICAGO
IL
606404689
Provider Mailing Phone/Fax
| Phone: | 7737690205 |
| Fax: |