Individual
MR. COLIN JAMES PETERS I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
6550 N. TALMAN AVE, CHICAGO, IL 60645-5323
(773) 960-4282
Mailing address
2709 N MONTICELLO AVE # 1, CHICAGO, IL 60647-1131
(773) 960-4282
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18305
IL
1041C0700X
Clinical Social Worker
Primary
149.012356
IL
Other
Enumeration date
08/20/2007
Last updated
07/31/2014
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