Individual
MARK COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
740 QUAIL RIDGE DR BLDG D, WESTMONT, IL 60559-6148
(630) 581-0334
Mailing address
1019 S ASHLAND AVE, LA GRANGE, IL 60525-2822
(847) 212-4911
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
696825
IL
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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