Individual
LILLIAN HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
226 W ONTARIO ST STE 400C, CHICAGO, IL 60654-3619
(312) 912-7008
Mailing address
6824 S CALUMET AVE, CHICAGO, IL 60637-4005
(708) 668-5320
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7512-0001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75120001
—
IL
Enumeration date
08/15/2018
Last updated
08/15/2018
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