Individual
DR. ADAM SHARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D., LPC
Contact information
Practice address
32 MAIN ST, PARK RIDGE, IL 60068-4060
(847) 823-4444
Mailing address
32 MAIN ST, PARK RIDGE, IL 60068-4060
(847) 823-4444
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.012302
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633134
BC GROUP ID
—
01
—
1235100140
GROUP NPI
—
01
—
212481
GROUP PTAN
—
Enumeration date
09/16/2016
Last updated
09/16/2016
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