Hall, Willie

Hall, Willie is an sole proprietor health care provider with primary practice located at 1100 W Cermak Rd , Chicago IL 60608-4500. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Hall, Willie can be contacted via phone (312) 568-7051.

Contact Information

Primary practice address
1100 W Cermak Rd Chicago IL 60608-4500
Phone: (312) 568-7051
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1306363445
LBN Legal business name Hall, Willie
Credentials CADC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 29th, 2017
Last updated Aug 29th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306363445 NPPES
Illinois MEDICAID 273984627001

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