| Grief Recovery Group, Inc | |
|
1010 Lake Street Suite 620 Oak Park IL 60301 | |
| (708) 359-5225 | |
| Not Available |
| Full Name | Grief Recovery Group, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 1010 Lake Street, Oak Park, Illinois |
| Authorized Official Name and Position | Mary Ann Hartnett (PRESIDENT) |
| Authorized Official Contact | 7083595225 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grief Recovery Group, Inc 1930 N Harlem Ave Apt 503 Elmwood Park IL 60707-3759 Ph: (708) 359-5225 | Grief Recovery Group, Inc 1010 Lake Street Suite 620 Oak Park IL 60301 Ph: (708) 359-5225 |
| NPI Number | 1356755334 |
|---|---|
| Provider Enumeration Date | 06/17/2014 |
| Last Update Date | 10/04/2019 |
| Medicare PECOS PAC ID | 7416170352 |
|---|---|
| Medicare Enrollment ID | O20140522001343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356755334 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.013125 (Illinois) | Primary |
| Provider Name | Mary Ann Hartnett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568668515 PECOS PAC ID: 8224161161 Enrollment ID: I20100729000498 |
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