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Individual

DEREK VINCENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
1263 W LOYOLA AVE, CHICAGO, IL 60626-6537
(773) 274-4600
Mailing address
1632 RIVERVIEW AVE, DES PLAINES, IL 60018-2263

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180012640
IL

Other

Enumeration date
08/18/2019
Last updated
12/26/2019
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