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Individual

MR. BERT FOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
5412 N CLARK ST STE 227, CHICAGO, IL 60640-1223
(773) 673-9095
Mailing address
5412 N CLARK ST STE 227, CHICAGO, IL 60640-1223
(773) 673-9095

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.012648
IL

Other

Enumeration date
11/17/2017
Last updated
12/20/2019
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