| North Park Clinic, S.c. | |
|
444 N Northwest Hwy Ste 170 Park Ridge IL 60068-6402 | |
| (847) 692-7101 | |
| (847) 692-7126 |
| Full Name | North Park Clinic, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 444 N Northwest Hwy Ste 170, Park Ridge, Illinois |
| Authorized Official Name and Position | Dickie Kay (OWNER) |
| Authorized Official Contact | 8476927101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Park Clinic, S.c. 444 N Northwest Hwy Ste 170 Park Ridge IL 60068-6402 Ph: (847) 692-7101 | North Park Clinic, S.c. 444 N Northwest Hwy Ste 170 Park Ridge IL 60068-6402 Ph: (847) 692-7101 |
| NPI Number | 1275630444 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6800981549 |
|---|---|
| Medicare Enrollment ID | O20070926000964 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275630444 | NPI | - | NPPES |
| 0001615772 | Other | IL | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Illinois) | Primary |
| Provider Name | Dickie Kay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497846042 PECOS PAC ID: 7416847009 Enrollment ID: I20040317001171 |
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