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NPI Code Detail

MEDICARE: PAMELA BURSE

MEDICARE: PAMELA BURSE
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 Counselor

General Provider Information

NPI Number : 1457668469
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA BURSE
Provider Business Mailing Address
First Line : 333 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3900
Country : US
Telephone Number : 312-747-0881
Fax Number : 312-747-7796
Provider Business Practice Location Address
First Line : 1140 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60620-3029
Country : US
Telephone Number : 312-747-0881
Fax Number : 312-747-7796
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2010
Last Update Date : 09/13/2010

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Directions to “ PAMELA BURSE ” 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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