Organization
THE IDS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID CHARLES IDERAN LCPC (DIRECTOR)
(630) 893-8470
Entity
Organization
Contact information
Practice address
644 E IRVING PARK RD, ROSELLE, IL 60172-2303
(630) 893-8470
Mailing address
644 E IRVING PARK RD, ROSELLE, IL 60172-2303
(630) 893-8470
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A31870006A
IL
Other
Enumeration date
08/25/2016
Last updated
08/25/2016
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