Individual
CRAIG STALLINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.P.C.
Contact information
Practice address
3815 HARRISON AVE, ROCKFORD, IL 61108-7631
(815) 391-1000
(815) 391-5040
Mailing address
1021 N MULFORD RD, ROCKFORD, IL 61107-3877
(815) 387-5600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180-005764
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15203
C.A.D.C.
IL
Enumeration date
02/01/2012
Last updated
02/01/2012
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