Individual
DOUGLAS L. ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP
Contact information
Practice address
226 W ONTARIO ST STE 400C, CHICAGO, IL 60654-3619
(312) 912-7008
(312) 533-2842
Mailing address
226 W ONTARIO ST, CHICAGO, IL 60654-3619
(708) 728-5470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21082
IL
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7512-0001
—
IL
Enumeration date
12/23/2010
Last updated
04/14/2020
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