Individual
EDWIN JOSEPH THULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1938 E LINCOLN HWY UNIT 219, NEW LENOX, IL 60451-3860
(815) 320-3749
(815) 320-3825
Mailing address
3105 W 102ND ST, EVERGREEN PARK, IL 60805-3516
(312) 718-3495
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
149.018135
IL
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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