Papa Ndomu Adams

Individual provider Active NPI Professional Counselor · Chicago, IL

NPI 1346717345 · NPPES record last updated Oct 28, 2018

Key facts

NPI
1346717345
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
180010814 (IL)
Practice address
4305 N Lincoln Ave
Chicago, IL 60618-1807
Phone
(847) 712-6299
NPI assigned
Oct 28, 2018
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
180010814ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180010814 IL Yes

Addresses

Primary practice location

4305 N Lincoln Ave
Chicago, IL 60618-1807

Mailing address

1904 W Pratt Blvd Apt 2B
Chicago, IL 60626-3165

Other providers in Chicago, IL

All providers in Chicago, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.