DR. FRED LEE NANCE JR.


Address: 17239 Evans Ave, South Holland, IL 60473-3436
Phone: 7089211395

DR. FRED LEE NANCE JR. (NPI# 1932614831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1932614831
Entity Type Individual
Full Name DR. FRED LEE NANCE JR.
Credential PHD, M.A.
Practice Address 17239 Evans Ave
South Holland
IL 60473-3436
Practice Telephone 7089211395
Mailing Telephone 7089211395
Enumeration Date 2017-12-13
Last Update Date 2017-12-18
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
22860 IL Behavioral Health & Social Service Providers

Office Location

Street Address 17239 EVANS AVE
City SOUTH HOLLAND
State IL
Zip Code 60473-3436

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City SOUTH HOLLAND
Zip Code 60473

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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