Provider Information for 1598130841
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RICHARD HELLER LCPC, MDiv
Sex: Male
NPI: 1598130841
Last Updated: 2015-12-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||||||
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| NPI | 1598130841 | ||||||||||||||||||||
| Enumeration Date | 2015-12-10 | ||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||
| Status | Active | ||||||||||||||||||||
| Mailing Address | 1832 W CRESCENT AVE PARK RIDGE, IL 60068-3878 United States Phone: 847-823-4767 | Fax: | ||||||||||||||||||||
| Primary Practice Address | 107 N WOOD DALE RD WOOD DALE, IL 60191-2029 United States Phone: 847-571-7015 | Fax: | ||||||||||||||||||||
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