Individual
TAMMY A DEVRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
585 TOLLGATE RD, ELGIN, IL 60123-9323
(815) 861-2006
Mailing address
669 ACADIA CIR, CRYSTAL LAKE, IL 60014-1915
(815) 861-2006
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19865
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164508149
—
IL
Enumeration date
10/23/2017
Last updated
10/23/2017
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