Individual
MR. JEFFREY L. VANDENBUSSCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCPC
Contact information
Practice address
410 S MICHIGAN AVE STE 928, CHICAGO, IL 60605-1399
(312) 248-3190
Mailing address
1242 W WINONA ST UNIT 1, CHICAGO, IL 60640-2908
(773) 271-1312
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.008984
IL
101YP2500X
Professional Counselor
Primary
180.011982
IL
106H00000X
Marriage & Family Therapist
208.000303
IL
Other
Enumeration date
02/13/2013
Last updated
10/25/2023
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