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NPI Code Detail

MEDICARE: TPA NETWORK INCORPORATED

MEDICARE: TPA NETWORK INCORPORATED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1174896914
Entity Type Code : Organization
Provider Name (Legal Business Name) : TPA NETWORK INCORPORATED
Provider Business Mailing Address
First Line : PO BOX 18412
Second Line :
City : PALATINE
State : IL
Zip : 60055-0001
Country : US
Telephone Number : 866-525-5414
Fax Number :
Provider Business Practice Location Address
First Line : 5537 N BROADWAY ST
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1405
Country : US
Telephone Number : 773-989-9400
Fax Number : 773-989-9494
Authorized Official
Title or Position : PROVIDER ENROLLMENT MANAGER
Name : TANYA MAULDIN
Credential :
Telephone Number : 414-225-1611
Provider Enumeration Date : 02/09/2012
Last Update Date : 05/14/2025

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Directions to “TPA NETWORK INCORPORATED ” Practice Location

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