Individual
BARRY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 W NORTH AVE, CHICAGO, IL 60610-1237
(312) 476-9064
Mailing address
2215 W CARMEN AVE # 3, CHICAGO, IL 60625-1819
(708) 401-0830
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
34782
IL
101YM0800X
Mental Health Counselor
Primary
180.012998
IL
Other
Enumeration date
09/03/2020
Last updated
09/04/2020
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