Individual
RONALD W KANWISCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
319 E MADISON ST, SPRINGFIELD, IL 62701-1035
(217) 545-8000
(217) 545-2275
Mailing address
PO BOX 19642, SPRINGFIELD, IL 62794-9642
(217) 545-8000
(217) 545-2275
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180-000692
IL
101YP2500X
Professional Counselor
180-000692
IL
Other
Enumeration date
01/04/2006
Last updated
10/03/2018
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