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General NPI Number Information
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NPI Number | 1598032922
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Entity Type | Organization
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Legal Business Name | DR. DEBRA M. BLOCK AND ASSOCIATES, MINDFUL SOLUTIONS LLC
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 1275 SHERMER RD SUITE 2
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City | NORTHBROOK
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State | IL
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Zip | 60062-4558
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Country | US
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Telephone | 847-409-0050
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Fax |
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Provider Business Mailing Address
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Address Line | 2740 W FOSTER AVE SUITE 109
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City | CHICAGO
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State | IL
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Zip | 60625-3500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DEBRA M. BLOCK
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Credential |
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Telephone | 847-409-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 071006426
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License Number State | IL
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