Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003180225 |
---|---|
Provider Name | Ms. Margaret Rogers |
First Address | Vernon Hills, IL 60061-2321 |
Second Address | Vernon Hills, IL 60061-1567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2012 |
Last Update Date | 06/03/2012 |