| Department Of Health And Human Services | |
|
14714 State St Dolton IL 60419-1517 | |
| (708) 267-3088 | |
| Not Available |
| Full Name | Department Of Health And Human Services |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 14714 State St, Dolton, Illinois |
| Authorized Official Name and Position | Pearl D Ballard (REGISTERED NURSE) |
| Authorized Official Contact | 7082673088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Department Of Health And Human Services 14714 State St Dolton IL 60419-1517 Ph: (708) 267-3088 | Department Of Health And Human Services 14714 State St Dolton IL 60419-1517 Ph: (708) 267-3088 |
| NPI Number | 1457883431 |
|---|---|
| Provider Enumeration Date | 03/30/2017 |
| Last Update Date | 03/30/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457883431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 041296287 (Illinois) | Primary |
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