Individual
CHAD DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008612
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071008612
DEPT. OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
11/17/2015
Last updated
11/17/2015
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