Individual
GLINDA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC/MISA1
Contact information
Practice address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3333
Mailing address
1909 CHEKER SQ, EAST HAZEL CREST, IL 60429-1442
(708) 647-3333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
25638
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25638
ILLINOIS CERTIFICATION BOARD INC.
IL
Enumeration date
04/07/2016
Last updated
04/07/2016
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