Individual
MS. JUDITH A FAWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CADC
Contact information
Practice address
139 FAIRFIELD LN, CAROL STREAM, IL 60188-3063
(312) 303-5015
(312) 759-5015
Mailing address
139 FAIRFIELD LN, CAROL STREAM, IL 60188-3063
(312) 303-5015
(312) 759-5015
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.009127
LICENSED CLINICAL PROFESSIONAL COUNSELOR
IL
Enumeration date
09/02/2009
Last updated
02/18/2015
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