Individual
NICHOLAS ANDRE HENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5307 W QUINCY ST, CHICAGO, IL 60644-4259
(773) 391-2544
Mailing address
5307 W QUINCY ST, CHICAGO, IL 60644-4259
(773) 391-2544
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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