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NPI Code Detail

MEDICARE: MR. RONALD WAYNE SUMPTER M.A.

MEDICARE:  MR. RONALD WAYNE SUMPTER  M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor180004413IL

General Provider Information

NPI Number : 1720225915
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RONALD WAYNE SUMPTER M.A.
Provider Business Mailing Address
First Line : 3225 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2210
Country : US
Telephone Number : 773-549-5886
Fax Number : 773-549-5892
Provider Business Practice Location Address
First Line : 3225 N SHEFFIELD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-2210
Country : US
Telephone Number : 773-549-5886
Fax Number : 773-549-5892
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2009
Last Update Date : 11/20/2009

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Directions to “ MR. RONALD WAYNE SUMPTER M.A.” Practice Location

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