Jose Manuel Malagon Jr, | |
1784 Whirlaway Ct, Glendale Heights, IL 60139-1300 | |
(219) 629-4416 | |
Not Available |
Full Name | Jose Manuel Malagon Jr |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 1784 Whirlaway Ct, Glendale Heights, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437625183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 149020200 (Illinois) | Primary |
Entity Name | Blue Moon Senior Counseling Of Illinois Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841562931 PECOS PAC ID: 7012172893 Enrollment ID: O20120628000431 |
Mailing Address | Practice Location Address |
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Jose Manuel Malagon Jr, 1784 Whirlaway Ct, Glendale Heights, IL 60139-1300 Ph: (219) 629-4416 | Jose Manuel Malagon Jr, 1784 Whirlaway Ct, Glendale Heights, IL 60139-1300 Ph: (219) 629-4416 |
Ashley Black, Counselor Medicare: Not Enrolled in Medicare Practice Location: 425 James Ct Unit D, Glendale Heights, IL 60139 Phone: 630-397-8100 | |
Ms. Kimberly Kallmann, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 Bloomingdale Rd, Glendale Heights, IL 60139 Phone: 630-221-1617 | |
Gina Depirro, Counselor Medicare: Not Enrolled in Medicare Practice Location: 731 Lippert Ln, Glendale Heights, IL 60139 Phone: 630-644-8269 | |
Mrs. Kimberly Shannon Duris, LCPC, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1701 Bloomingdale Rd, Glendale Heights, IL 60139 Phone: 630-221-1617 | |
Mrs. Lindsay T Schori, Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 E Army Trail Rd, Glendale Heights, IL 60139 Phone: 630-209-7253 | |
Cai Fasse, Counselor Medicare: Not Enrolled in Medicare Practice Location: 533 Darlene Ln Unit B, Glendale Heights, IL 60139 Phone: 630-207-7134 |