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General NPI Number Information
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NPI Number | 1568376903
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Entity Type | Organization
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Legal Business Name | PURPLE PATH
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 25741 S TRUMAN ST
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City | MONEE
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State | IL
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Zip | 60449-8062
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Country | US
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Telephone | 708-627-0620
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Fax |
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Provider Business Mailing Address
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Address Line | 25741 S TRUMAN ST
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City | MONEE
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State | IL
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Zip | 60449-8062
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Country | US
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Telephone | 708-627-0620
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | DR. SHANIQUA JONES
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Credential | QMHP
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Telephone | 773-494-2696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State | NULL
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