Individual provider · Type 1 NPI

David Fireside, LCMT

Specialist · Deerfield, IL

NPI number 1134526171 Active

Practice location

108 Wilmot Rd
Deerfield, IL 60015-5145

Call (847) 580-0002 Map

Mailing address

1244 Taylor Ave
Highland Park, IL 60035-2360

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X227.009223 (IL)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1134526171

David Fireside, LCMT's National Provider Identifier is 1134526171, issued on Nov 19, 2014. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Deerfield, IL. The record was last updated on Nov 19, 2014.