Wall, Andrew R

Wall, Andrew R is an sole proprietor health care provider with primary practice located at 2302 W North Ave Unit 1E, Chicago IL 60647-6260. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Wall, Andrew R can be contacted via phone (773) 551-7204.

Contact Information

Primary practice address
2302 W North Ave Unit 1E Chicago IL 60647-6260
Phone: (773) 551-7204
Fax: (773) 342-4200
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 180008228 Illinois
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 180008228 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 180008228 Illinois
Behavioral Health & Social Service Providers / Professional 101YP2500X 180008228 Illinois

Profile Details

NPI number 1376899799
LBN Legal business name Wall, Andrew R
Credentials LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 3rd, 2012
Last updated Oct 2nd, 2014 - about 11 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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