Healthcare Provider Details

I. General information

NPI: 1396260683
Provider Name (Legal Business Name): PEARLS OF HOPE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4137 SAUK TRL STE 148
RICHTON PARK IL
60471-1253
US

IV. Provider business mailing address

21333 CARLTON ST
CREST HILL IL
60403-1178
US

V. Phone/Fax

Practice location:
  • Phone: 312-600-3612
  • Fax: 312-847-8405
Mailing address:
  • Phone:
  • Fax: 815-630-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number180008970
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number180008970
License Number State

VIII. Authorized Official

Name: PEAORL PARKS
Title or Position: OWNER
Credential: LCPC
Phone: 815-603-4310