NPI 1245913987

Warren Other Ballentine

Practitioner Peer Specialist Chicago, IL

Practice location

Address: 219 W Chicago Ave, Chicago, IL 60654-5600
Phone: (919) 672-1818

Registered specialties

Peer Specialist Primary

Other Service Providers Taxonomy 175T00000X

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Registry record

NPI: 1245913987
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2023
Record last updated: 9 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.