person
Russell Bergtold
Addiction (Substance Use Disorder) Counselor in East Hazel Crest, Illinois
NPI 1982266698

Russell Bergtold is an Addiction (Substance Use Disorder) Counselor based in East Hazel Crest, IL and is specialized in Addiction (Substance Use Disorder). Russell Bergtold practices in East Hazel Crest, IL. The NPI Number for Russell Bergtold is 1982266698 and holds a License No. (Illinois).

The current practice location address for Russell Bergtold is 1909 Cheker Sq, East Hazel Crest, IL and can be reached out via phone at 708-647-3333.

Location: 1909 Cheker Sq, East Hazel Crest, IL, 60429-1442
person
Provider Profile Details
NPI Number
1982266698
Provider Name
Russell Bergtold
Credential
Provider Entity Type
Individual
Gender
Male
Address
1909 Cheker Sq, East Hazel Crest, IL, 60429-1442
Phone Number
708-647-3333
Fax Number
Provider Enumeration Date
07/02/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NA 01 NA
institution
Provider Business Practice Location Address Details
Address
1909 Cheker Sq
City
State
Zip
60429-1442
Phone Number
708-647-3333
Fax Number
person
Provider Business Mailing Address Details
Address
1909 Cheker Sq
City
State
Zip
60429-1442
Phone Number
708-647-3333
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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