Individual
MR. WILLIE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
1100 W CERMAK RD, CHICAGO, IL 60608-4500
(312) 568-7051
Mailing address
1100 W CERMAK RD, CHICAGO, IL 60608-4500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273984627001
—
IL
Enumeration date
08/29/2017
Last updated
08/29/2017
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