Willie Larry Blackmon in Chicago - Addiction (substance Use Disorder)
Willie Larry Blackmon - NPI 1477762052
Willie Larry Blackmon is a Addiction (substance Use Disorder) in Chicago, Illinois. Willie Larry Blackmon practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Willie Larry Blackmon is 1477762052. The last update date is 2009-04-23.
Willie Larry Blackmon's current location address is 5834 S Maplewood Ave, Chicago, Illinois. You can contact this provider via phone number 7737784835 and fax number 7737784835. The mailing address for Willie Larry Blackmon is 5834 S Maplewood Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Willie Larry Blackmon |
|---|---|
| Address | 5834 S Maplewood Ave, Chicago, Illinois |
| Phone Number | 7737784835 |
| Fax Number | 7737784835 |
| Sole Proprietor | N |
| Credentials | LCPC; CADC |
NPI Number Detail
| NPI Number | 1477762052 |
|---|---|
| Provider Enumeration Date | 2007-05-21 |
| Last Updated Date | 2009-04-23 |
Provider Mailing Address Detail
| Address | 5834 S Maplewood Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606291124 |
| Phone Number | 7737784835 |
| Fax Number | 7737784835 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 5848 |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Post Comment/ Review Below
What is the Willie Larry Blackmon's unique identification number?
The Willie Larry Blackmon has been assigned the NPI (National Provider Identifier) Number 1477762052 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Willie Larry Blackmon is geographically located?
The Willie Larry Blackmon is physically situated at the following location: 5834 S Maplewood Ave, Chicago, IL, 606291124.
What is Willie Larry Blackmon's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Willie Larry Blackmon is Addiction (substance Use Disorder), and the taxonomy code that classifies this field of practice is 101Ya0400X.
On what date did the Centers for Medicare & Medicaid Services issue the 1477762052 to Willie Larry Blackmon?
The Willie Larry Blackmon received its 1477762052 assignment from the Centers for Medicare & Medicaid Services on 2007-05-21.
As of what date were the Willie Larry Blackmon's details last updated?
The information pertaining to the Willie Larry Blackmon, including its address, specialty, and other details, was most recently updated on 2009-04-23.