Individual
DAVID BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3333
Mailing address
2740 CHAYES CT APT D, HOMEWOOD, IL 60430-2942
(708) 997-2239
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17095
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17095
CADC
IL
Enumeration date
04/08/2016
Last updated
04/08/2016
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