Mouton, Andrew B
Mouton, Andrew B is an individual health care provider with primary practice located at 10640 W 165Th Street , Orland Park IL 60467-5653. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Mouton, Andrew B can be contacted via phone (708) 364-0261.Contact Information
Primary practice address
10640 W 165Th Street
Orland Park IL 60467-5653
Phone: (708) 364-0261
Fax: (708) 364-6019
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 071004325 | Illinois |
Profile Details
| NPI number | 1477500825 |
|---|---|
| LBN Legal business name | Mouton, Andrew B |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | May 13th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477500825 | NPPES |
| Illinois | Other | 071004325 | STATE LICENSE |
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