Individual
MR. MICHAEL PETITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
12 HEALTH SERVICES DRIVE, DEKALB, IL 60115
(815) 756-4875
(815) 756-2944
Mailing address
12 HEALTH SERVICES DRIVE, DEKALB, IL 60115
(815) 756-4875
(815) 756-2944
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
30401
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30401
CADC
IL
Enumeration date
06/24/2013
Last updated
06/24/2013
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