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General NPI Number Information
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NPI Number | 1639312580
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Entity Type | Organization
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Legal Business Name | DUI COUNSELING CENTER OF KENDALL COUNTY
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 04/08/2009
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Provider Practice Location Address
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Address Line | 115 E SOUTH ST
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City | PLANO
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State | IL
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Zip | 60545-1417
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Country | US
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Telephone | 630-552-9910
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Fax | 630-552-9920
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Provider Business Mailing Address
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Address Line | 115 E SOUTH ST P O BOX 282
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City | PLANO
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State | IL
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Zip | 60545-1417
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Country | US
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Telephone | 630-552-9910
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Fax | 630-552-9920
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Authorized Official
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Title or Position | DIRECTOR
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Name | RON PARTCH JR.
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Credential | MS, CRADC, SAP
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Telephone | 630-552-9910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | A20710016A
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | A20710016A
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License Number State | IL
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