Individual
REVELL BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC AAS
Contact information
Practice address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
(847) 360-7377
Mailing address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8200
(847) 360-7377
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22561
IL
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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