Individual
MR. FORD WILLOUGHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCPC
Contact information
Practice address
1029 LAKE ST, OAK PARK, IL 60301-1104
(708) 271-2864
Mailing address
225 S TAYLOR AVE, OAK PARK, IL 60302-3323
(708) 271-2864
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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