Jamie Mirocha Inc. | |
24012 W Renwick Road Plainfield IL 60544 | |
(815) 676-4688 | |
(815) 676-4498 |
Full Name | Jamie Mirocha Inc. |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 24012 W Renwick Road, Plainfield, Illinois |
Authorized Official Name and Position | Jamie Mirocha (THERAPIST) |
Authorized Official Contact | 8156764688 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jamie Mirocha Inc. 24012 W Renwick Rd Plainfield IL 60544-8731 Ph: (815) 676-4688 | Jamie Mirocha Inc. 24012 W Renwick Road Plainfield IL 60544 Ph: (815) 676-4688 |
NPI Number | 1073024576 |
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Provider Enumeration Date | 10/24/2017 |
Last Update Date | 10/24/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073024576 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 149017464 (Illinois) | Primary |
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