DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: LATREAVETTE LATISH MCCLINE

MEDICARE: LATREAVETTE LATISH MCCLINE
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
1101YM0800XMental Health CounselorIL
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1720621527
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATREAVETTE LATISH MCCLINE
Provider Business Mailing Address
First Line : 213 E CASS ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-2812
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 213 E CASS ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-2812
Country : US
Telephone Number : 630-551-8718
Fax Number : 815-726-2708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2019
Last Update Date : 01/27/2025

Similar Medicare Providers

1053252668 — WILL GRUNDY MEDICAL CENTER
Practice Location Address:
213 E CASS ST
JOLIET, IL
60432-2812
Practice Phone: 815-726-3377
Practice Fax: 815-726-3377
1275543696 — GARY LIPINSKI M.D.
Practice Location Address:
213 E CASS ST
JOLIET, IL
60432-2812
Practice Phone: 815-726-3377
Practice Fax:
1346528486 — DR. ROBERT D QUEVILLON MD
Practice Location Address:
213 E CASS ST
JOLIET, IL
60432-2812
Practice Phone: 815-726-3377
Practice Fax:
1427317262 — DR. DESMOND THOMAS WHITE M.D.
Practice Location Address:
213 E CASS ST
JOLIET, IL
60432-2812
Practice Phone: 815-726-3377
Practice Fax:
1306516075 — WILL-GRUNDY MEDICAL CLINIC, INC
Practice Location Address:
213 E CASS ST
JOLIET, IL
60432-2812
Practice Phone: 815-726-5112
Practice Fax:
1972776516 — DR. BAZGHA SIDDIQUI M.D
Practice Location Address:
1051 ESSINGTON ROAD , SUITE 210
JOLIET, IL
60435-2812
Practice Phone: 815-726-1818
Practice Fax: 815-726-0232

Directions to “ LATREAVETTE LATISH MCCLINE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.