Healthcare Provider Details

I. General information

NPI: 1770857526
Provider Name (Legal Business Name): MISS EVETTE BARBRE'
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2012
Last Update Date: 02/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24647 N MILWAUKEE AVE
VERNON HILLS IL
60061-1567
US

IV. Provider business mailing address

6757 99TH PL UNIT B
PLEASANT PRAIRIE WI
53158-3378
US

V. Phone/Fax

Practice location:
  • Phone: 847-377-7950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: