Individual
DR. FRED LEE NANCE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, M.A.
Contact information
Practice address
17239 EVANS AVE, SOUTH HOLLAND, IL 60473-3436
(708) 921-1395
Mailing address
17239 EVANS AVE, SOUTH HOLLAND, IL 60473-3436
(708) 921-1395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
22860
IL
Other
Enumeration date
12/13/2017
Last updated
12/18/2017
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