MEDICARE: NEW PATHS CLINICAL SERVICES, P.C.

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
1	101YM0800X	Mental Health Counselor		IL

General Provider Information

NPI Number	:	1518005750
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW PATHS CLINICAL SERVICES, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 5432
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-5432
Country	:	US
Telephone Number	:	630-260-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1553 BLOOMINGDALE RD
Second Line	:	SUITE 1100
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-2751
Country	:	US
Telephone Number	:	630-260-1700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. KIMBERLY SHANNON DURIS
Credential	:	LCPC, CADC
Telephone Number	:	630-260-1700

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/22/2020

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