Robert Francis Oconnor, CADC , PCGC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Broadview, IL
NPI 1629316534 · NPPES record last updated Jan 28, 2013
Key facts
- NPI
- 1629316534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 22857 (IL)
- Practice address
- 1915 W Roosevelt Rd
Broadview, IL 60155-2925 - Phone
- (708) 344-3301
- Fax
- (798) 344-2944
- NPI assigned
- Jan 28, 2013
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22857 | IL | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 22857 | IL | Yes |
Addresses
Primary practice location
1915 W Roosevelt Rd
Broadview, IL 60155-2925
Mailing address
1915 W Roosevelt Rd
Broadview, IL 60155-2925
Phone (708) 344-3301
Other providers in Broadview, IL
- Navnit J Nathwani
- National Seating & Mobility, Inc
- Marva Ann Newman
- Adam Charles Niemeyer
- Jewel Dean Nolden
- Pathways to Intentional Therapy and Consulting LLC
- Patricia M Moser OD PC
- Genoveva Perez
- Kenita J. Perry-Bell
- David Phan
All providers in Broadview, IL · Addiction (Substance Use Disorder) Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.