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General NPI Number Information
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NPI Number | 1023832698
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Entity Type | Individual
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Provider Name | JAMES ROLLINSON THORNTON M.A.
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Gender | Male
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Dates
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Enumeration Date | 11/11/2024
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Last Update Date | 11/11/2024
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Provider Practice Location Address
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Address Line | 2603 W 22ND ST STE 23
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City | OAK BROOK
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State | IL
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Zip | 60523-1237
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Country | US
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Telephone | 630-986-0599
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Fax |
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Provider Business Mailing Address
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Address Line | 480 N MCCLURG CT APT 1212
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City | CHICAGO
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State | IL
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Zip | 60611-4336
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Country | US
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Telephone | 612-802-4838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.016143
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License Number State | IL
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