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General NPI Number Information
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NPI Number | 1073681680
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Entity Type | Organization
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Legal Business Name | INSEARCH
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 05/31/2012
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Provider Practice Location Address
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Address Line | 201 E ARMY TRAIL ROAD 300D
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2106
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Country | US
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Telephone | 630-530-2220
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Fax | 773-665-1269
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Provider Business Mailing Address
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Address Line | 201 E ARMY TRAIL ROAD 300D
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2106
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Country | US
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Telephone | 630-530-2220
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Fax | 773-665-1269
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MARK T KENNY
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Credential | LCPC
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Telephone | 630-530-2220
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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 | 180000746
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License Number State | IL
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