| Championz Korner | |
|
405 N Euclid Ave Oak Park IL 60302 | |
| (708) 665-5443 | |
| Not Available |
| Full Name | Championz Korner |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 405 N Euclid Ave, Oak Park, Illinois |
| Authorized Official Name and Position | Valencia Williams (OWNER) |
| Authorized Official Contact | 7086655443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Championz Korner 405 N Euclid Ave Oak Park IL 60302-2111 Ph: (708) 665-5443 | Championz Korner 405 N Euclid Ave Oak Park IL 60302 Ph: (708) 665-5443 |
| NPI Number | 1033855655 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 07/27/2022 |
| Certification Date | 07/27/2022 |
| Medicare PECOS PAC ID | 0648647909 |
|---|---|
| Medicare Enrollment ID | O20221031001517 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033855655 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Valencia Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528421229 PECOS PAC ID: 2466829726 Enrollment ID: I20221031001612 |
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