Healthcare Provider Details

I. General information

NPI: 1366357287
Provider Name (Legal Business Name): MS. PARIS MONIQUE MCCLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10522 S CICERO AVE STE 404
OAK LAWN IL
60453-5290
US

IV. Provider business mailing address

637 RICE AVE
BELLWOOD IL
60104-1862
US

V. Phone/Fax

Practice location:
  • Phone: 708-818-8825
  • Fax: 872-244-0709
Mailing address:
  • Phone: 708-539-2726
  • Fax: 872-244-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.119212
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: