| Muddworks, Inc. | |
|
708 Church St Suite 258 Evanston IL 60201-3875 | |
| (847) 332-2589 | |
| (847) 332-2609 |
| Full Name | Muddworks, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 708 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Peter Michael Mudd (PRESIDENT) |
| Authorized Official Contact | 8473322589 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Muddworks, Inc. 708 Church St Suite 258 Evanston IL 60201-3875 Ph: (847) 332-2589 | Muddworks, Inc. 708 Church St Suite 258 Evanston IL 60201-3875 Ph: (847) 332-2589 |
| NPI Number | 1174659924 |
|---|---|
| Provider Enumeration Date | 02/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174659924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
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