Individual
BRENT SHOWALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4442 N BEACON ST APT 3, CHICAGO, IL 60640-6265
(573) 289-4745
Mailing address
4442 N BEACON ST APT 3, CHICAGO, IL 60640-6265
(573) 289-4745
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.017916
IL
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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