Individual
ANTIONETTE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 W BRADLEY PL, CHICAGO, IL 60618-4716
(773) 739-5808
Mailing address
7754 S CHRISTIANA AVE, CHICAGO, IL 60652-1512
(773) 414-4198
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
180.016471
IL
Other
Enumeration date
07/13/2020
Last updated
01/06/2025
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