Individual
MR. ERIC VICENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
5000 S 5TH AVE, BUILDING 228, 4N, HINES, IL 60141-3030
(708) 202-4948
Mailing address
5000 S 5TH AVE, BUILDING 228, 4N, HINES, IL 60141-3030
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150101587
IL
1041C0700X
Clinical Social Worker
Primary
149.021206
IL
Other
Enumeration date
02/26/2016
Last updated
05/08/2019
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