| Kathleen E Cox Pc | |
|
5290 Williams Dr Roscoe IL 61073-9222 | |
| (815) 324-0324 | |
| (866) 927-3053 |
| Full Name | Kathleen E Cox Pc |
|---|---|
| Speciality | Counselor |
| Location | 5290 Williams Dr, Roscoe, Illinois |
| Authorized Official Name and Position | Kathleen Eunice Cox (OWNER) |
| Authorized Official Contact | 8153240324 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen E Cox Pc 5290 Williams Dr Roscoe IL 61073-9222 Ph: (815) 324-0324 | Kathleen E Cox Pc 5290 Williams Dr Roscoe IL 61073-9222 Ph: (815) 324-0324 |
| NPI Number | 1821360181 |
|---|---|
| Provider Enumeration Date | 02/02/2012 |
| Last Update Date | 02/20/2024 |
| Certification Date | 02/20/2024 |
| Medicare PECOS PAC ID | 3173962339 |
|---|---|
| Medicare Enrollment ID | O20240419003186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821360181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Kathleen Eunice Cox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770628166 PECOS PAC ID: 6800235060 Enrollment ID: I20240419003336 |
| Provider Name | Alisa Klatt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063897841 PECOS PAC ID: 7810336948 Enrollment ID: I20240422001970 |
| Provider Name | Erin M Bergren |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215609797 PECOS PAC ID: 9335589605 Enrollment ID: I20240503000516 |
| Provider Name | Misty Elizabeth Chipalla |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356031777 PECOS PAC ID: 0042650350 Enrollment ID: I20240503001797 |
| Provider Name | Benjamin Mullineaux |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164925848 PECOS PAC ID: 7517309479 Enrollment ID: I20240523000192 |
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