Healthcare Provider Details

I. General information

NPI: 1093883043
Provider Name (Legal Business Name): PCLN & ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 09/20/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 RAVINIA PLACE STE 1
ORLAND PARK IL
60462
US

IV. Provider business mailing address

900 RAVINIA PLACE STE 1
ORLAND PARK IL
60462
US

V. Phone/Fax

Practice location:
  • Phone: 708-422-2898
  • Fax: 815-524-3566
Mailing address:
  • Phone: 708-422-2898
  • Fax: 815-524-3566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: PAULA COUGHLIN
Title or Position: OWNER/SOCIAL WORKER
Credential: LCSW BCD
Phone: 708-224-5104