George Campbell, C.A.D.C.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

6189 Issued in IL

Practice address

11191 Illinois Route 185
Hillsboro, IL 62049-2664

Phone

(217) 532-2001

Fax

(217) 532-6361

NPI assigned

Jan 11, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1053597773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11191 ILLINOIS ROUTE 185",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620492664",
            "telephone_number": "217-532-2001",
            "fax_number": "217-532-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11191 ILLINOIS ROUTE 185",
            "city": "HILLSBORO",
            "state": "IL",
            "postal_code": "620492664",
            "telephone_number": "217-532-2001",
            "fax_number": "217-532-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "GEORGE",
        "credential": "C.A.D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "6189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Hillsboro, IL
• Providers in Hillsboro, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.