Individual
ENRIQUE ESCAMILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
4230 11TH ST, ROCK ISLAND, IL 61201-6746
(309) 788-4571
(309) 788-7132
Mailing address
4230 11TH ST, ROCK ISLAND, IL 61201-6746
(309) 788-4571
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
30542
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
IL
Enumeration date
01/24/2018
Last updated
01/24/2018
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