Provider Demographics
NPI:1366845224
Name:FORWARD VISION, INC.
Entity Type:Organization
Organization Name:FORWARD VISION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:DANCY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:312-952-2006
Mailing Address - Street 1:10725 S WESTERN AVE
Mailing Address - Street 2:2ND. FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10725 S WESTERN AVE
Practice Address - Street 2:2ND. FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3135
Practice Address - Country:US
Practice Address - Phone:312-952-2006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003903305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization