| Doctor Name: | KEVIN BALL |
| NPI Number: | 1821411935 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | 22330 |
| Business Practice Address: | 316 S Main St Wauconda, IL - 600841985 |
| Business Phone Number: | 8473226695 |
| Business Fax Number: | |
| Mailing Address: | Po Box 945, MORTON GROVE |
| State: | IL |
| Postal Code: | 600530945 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2014 |
| NPI Last Update Date: | 04/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 22330 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |