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General NPI Number Information
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NPI Number | 1194903583
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Entity Type | Organization
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Legal Business Name | FORWARD VISION, INC.
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 1525 E 53RD ST STE 425
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City | CHICAGO
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State | IL
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Zip | 60615-4545
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Country | US
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Telephone | 312-952-2006
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 E 53RD ST STE 425
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City | CHICAGO
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State | IL
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Zip | 60615-4545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MS. ADRIENNE L DANCY
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Credential |
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Telephone | 312-952-2006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180003903
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License Number State | IL
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