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Individual

PATRICK VICKERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRC, LPC

Contact information

Practice address
820 S DAMEN AVE # 116-C, CHICAGO, IL 60612-3728
(312) 569-5846
(312) 569-5913
Mailing address
820 S DAMEN AVE # 116-C, CHICAGO, IL 60612-3728
(312) 569-5846
(312) 569-5913

Taxonomy

Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
00344723

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00344723
IDPFR
Enumeration date
01/21/2022
Last updated
01/21/2022
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