Individual
KEVIN M BUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MFA CRADC
Contact information
Practice address
325 IL ROUTE 2, DIXON, IL 61021-9118
(815) 284-6611
(815) 284-6591
Mailing address
3309 15TH AVE, STERLING, IL 61081-4005
(815) 626-3020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12799
CRADC- IAODAPCA
IL
Enumeration date
12/06/2006
Last updated
07/08/2007
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