Healthcare Provider Details

I. General information

NPI: 1922458934
Provider Name (Legal Business Name): PAPE & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2016
Last Update Date: 06/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 S WEST ST
WHEATON IL
60187-5000
US

IV. Provider business mailing address

618 S WEST ST
WHEATON IL
60187-5000
US

V. Phone/Fax

Practice location:
  • Phone: 630-668-8710
  • Fax: 630-668-8779
Mailing address:
  • Phone: 630-668-8710
  • Fax: 630-668-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149000437
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICIA A PAPE
Title or Position: OWNER
Credential: LCSW, CSADC
Phone: 630-668-8710