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19710 Governors Hwy Ste 5 Flossmoor IL 60422-2081 | |
| (708) 980-8622 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 19710 Governors Hwy Ste 5, Flossmoor, Illinois |
| Authorized Official Name and Position | Monique Simmons (OWNER/LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 7089808622 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
872 Greenbriar Ln University Park IL 60484-2807 Ph: (708) 998-6982 | 19710 Governors Hwy Ste 5 Flossmoor IL 60422-2081 Ph: (708) 980-8622 |
| NPI Number | 1669256947 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 01/02/2025 |
| Certification Date | 01/01/2025 |
| Medicare PECOS PAC ID | 1254785306 |
|---|---|
| Medicare Enrollment ID | O20230925000598 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669256947 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Monique Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831789346 PECOS PAC ID: 2163876210 Enrollment ID: I20230925000663 |
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