MEDICARE: MS. PATRICIA JOAN HARTHUN L.C.P.C., C.A.D.C.

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
1	101Y00000X	Counselor		IL

General Provider Information

NPI Number	:	1306866132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA JOAN HARTHUN L.C.P.C., C.A.D.C.

Provider Business Mailing Address
First Line	:	9546 S HAMILTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1120
Country	:	US
Telephone Number	:	312-835-7976
Fax Number	:	773-239-9857

Provider Business Practice Location Address
First Line	:	10725 S WESTERN AVE
Second Line	:	2ND FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60643-3135
Country	:	US
Telephone Number	:	312-835-7976
Fax Number	:	773-239-9857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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