Healthcare Provider Details
I. General information
NPI: 1245454313
Provider Name (Legal Business Name): JOHN DAY & ASSOCIATES, LTD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2007
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3716 W BRIGHTON
PEORIA IL
61615-2938
US
IV. Provider business mailing address
3716 W BRIGHTON
PEORIA IL
61615-2938
US
V. Phone/Fax
- Phone: 309-692-7755
- Fax: 309-692-2262
- Phone: 309-692-7755
- Fax: 309-692-2262
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
LUKE
R
DALFIUME
Title or Position: CO OWNER
Credential: PHD
Phone: 309-692-7755