Individual
BETZABE ADAME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2355 S WESTERN AVE, CHICAGO, IL 60608
(773) 254-1400
Mailing address
966 W 21ST ST, CHICAGO, IL 60608-4511
(773) 254-1400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180012521
IL
101YP2500X
Professional Counselor
178.011250
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
IL
Enumeration date
07/22/2013
Last updated
01/17/2024
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