Individual
MICHAEL LABELLART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
1113 W GREENWOOD AVE, WAUKEGAN, IL 60087-4908
(847) 244-4434
Mailing address
1113 W GREENWOOD AVE, WAUKEGAN, IL 60087-4908
(847) 244-4434
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16688
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16688
IAODAPCA
IL
Enumeration date
11/19/2015
Last updated
11/19/2015
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