Individual
MR. ANDREW RYAN PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
429 S HUNTLEY ST, MAPLE PARK, IL 60151-7618
(630) 885-8603
Mailing address
429 S HUNTLEY ST, MAPLE PARK, IL 60151-7618
(630) 885-8603
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.026691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
474579189001
—
IL
Enumeration date
02/11/2020
Last updated
08/27/2024
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