Healthcare Provider Details

I. General information

NPI: 1982965539
Provider Name (Legal Business Name): DUNCAN WILLIAM HALL LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16151 WEBER RD SUITE 101
CREST HILL IL
60403-0863
US

IV. Provider business mailing address

1000 REMINGTON BLVD SUITE 100 (PMG)
BOLINGBROOK IL
60440-5114
US

V. Phone/Fax

Practice location:
  • Phone: 815-773-7827
  • Fax: 815-838-2656
Mailing address:
  • Phone: 630-914-2417
  • Fax: 630-914-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149015171
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: