| Orland Park Counselors Pc | |
|
7021 W 153rd St Ste 5 Orland Park IL 60462-5397 | |
| (708) 275-0934 | |
| Not Available |
| Full Name | Orland Park Counselors Pc |
|---|---|
| Speciality | Counselor |
| Location | 7021 W 153rd St Ste 5, Orland Park, Illinois |
| Authorized Official Name and Position | Timothy Michael Jenkins (PRESIDENT) |
| Authorized Official Contact | 7082750934 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orland Park Counselors Pc Po Box 764 Manteno IL 60950-0764 Ph: (708) 275-0934 | Orland Park Counselors Pc 7021 W 153rd St Ste 5 Orland Park IL 60462-5397 Ph: (708) 275-0934 |
| NPI Number | 1982361408 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Medicare PECOS PAC ID | 5890233688 |
|---|---|
| Medicare Enrollment ID | O20240812001402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982361408 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Timothy Michael Jenkins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1043378250 PECOS PAC ID: 6709324593 Enrollment ID: I20240812001486 |
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