Individual
MR. BRYAN HEIDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
2950 W CHICAGO AVE, CHICAGO, IL 60622-4375
(773) 569-9553
Mailing address
1823 N SAINT LOUIS AVE, CHICAGO, IL 60647-4824
(177) 356-9955
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.011883
IL
Other
Enumeration date
11/07/2018
Last updated
11/13/2018
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