Individual
DR. MADISON BERESFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
265 EXCHANGE DR, SUITE 101B, CRYSTAL LAKE, IL 60014-6230
(224) 286-4673
Mailing address
265 EXCHANGE DR, SUITE 101B, CRYSTAL LAKE, IL 60014-6230
(224) 286-4673
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
12/30/2015
Last updated
01/04/2016
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