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NPI Code Detail

MEDICARE: PALOS PSYCHIATRIC & RECOVERY INST LTD

MEDICARE: PALOS PSYCHIATRIC & RECOVERY INST LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor18000637IL
2101YA0400XAddiction (Substance Use Disorder) CounselorIL
3103TC0700XClinical PsychologistIL
4104100000XSocial WorkerIL
5103TC0700XClinical PsychologistIL

General Provider Information

NPI Number : 1063497345
Entity Type Code : Organization
Provider Name (Legal Business Name) : PALOS PSYCHIATRIC & RECOVERY INST LTD
Provider Business Mailing Address
First Line : 7300 W COLLEGE DR
Second Line : SUITE 101
City : PALOS HEIGHTS
State : IL
Zip : 60463-1152
Country : US
Telephone Number : 708-448-8470
Fax Number : 708-448-9651
Provider Business Practice Location Address
First Line : 7300 W COLLEGE DR
Second Line : 101
City : PALOS HEIGHTS
State : IL
Zip : 60463-1152
Country : US
Telephone Number : 708-448-8470
Fax Number : 708-448-9651
Authorized Official
Title or Position : INS COORDINATOR
Name : MRS. DALIA COLLAZO
Credential :
Telephone Number : 708-448-8470
Provider Enumeration Date : 12/09/2005
Last Update Date : 12/11/2007

Similar Medicare Providers

1891786067 — DR. EUGENE MANDREA M.D.
Practice Location Address:
7300 W COLLEGE DR , SUITE 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378
1184615387 — EUGENE MANDREA, M.D., S.C.
Practice Location Address:
7300 W COLLEGE DR , SUITE1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378
1609851740 — NORTH SHORE WELLNESS CENTER LTD
Practice Location Address:
7300 W COLLEGE DR , SUITE 101
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-448-8470
Practice Fax: 708-448-9651
1639134224 — MS. DANIELLE P GLICKLEY LSW
Practice Location Address:
7300 W COLLEGE DR , 101
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-448-8470
Practice Fax: 708-448-9651
1770509648 — KEITH ALAN LOPATKA M.D.
Practice Location Address:
7300 W COLLEGE DR , STE 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378
1831110279 — MRS. BERNICE IK-JANG MI JOHNSON PHYISICAN ASSISTANT
Practice Location Address:
7300 W COLLEGE DR , 1NW
PALOS HEIGHTS, IL
60463-1152
Practice Phone: 708-671-1374
Practice Fax: 708-671-1378

Directions to “PALOS PSYCHIATRIC & RECOVERY INST LTD ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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