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NPI Code Detail

MEDICARE: DR. JOHN MICHAEL PALEN M.S., PH.D.

MEDICARE:  DR. JOHN MICHAEL PALEN  M.S., PH.D.
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
11041C0700XClinical Social Worker149001939IL

General Provider Information

NPI Number : 1710055520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN MICHAEL PALEN M.S., PH.D.
Provider Business Mailing Address
First Line : 5445 N SHERIDAN RD APT 2415
Second Line :
City : CHICAGO
State : IL
Zip : 60640-7471
Country : US
Telephone Number : 847-219-1877
Fax Number : 847-965-4177
Provider Business Practice Location Address
First Line : 5445 N SHERIDAN RD APT 2415
Second Line :
City : CHICAGO
State : IL
Zip : 60640-7471
Country : US
Telephone Number : 847-219-1877
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 09/07/2021

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Directions to “ DR. JOHN MICHAEL PALEN M.S., PH.D.” Practice Location

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