Individual
MARK EDWARD BEALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA OF SOCIAL WORK
Contact information
Practice address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3333
Mailing address
2401 CAPRI DR, SCHERERVILLE, IN 46375-2438
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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