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General NPI Number Information
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NPI Number | 1700264389
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Entity Type | Organization
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Legal Business Name | RECOVER RESTORE COUNSELING INC
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 625 N NORTH CT STE 350
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City | PALATINE
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State | IL
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Zip | 60067-8160
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Country | US
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Telephone | 224-801-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 625 N NORTH CT STE 350
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City | PALATINE
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State | IL
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Zip | 60067-8160
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Country | US
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Telephone | 224-801-1700
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ERIC CONNOR
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Credential | LCPC
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Telephone | 224-801-1700
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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 | 180.009658
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License Number State | IL
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