| Park Clinical Services, Pllc | |
|
2465 Moutray Ln North Aurora IL 60542-2111 | |
| (306) 335-0540 | |
| Not Available |
| Full Name | Park Clinical Services, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2465 Moutray Ln, North Aurora, Illinois |
| Authorized Official Name and Position | Marycarol Park (OWNER) |
| Authorized Official Contact | 6303350540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Clinical Services, Pllc Po Box 123 Batavia IL 60510-0123 Ph: (630) 335-0540 | Park Clinical Services, Pllc 2465 Moutray Ln North Aurora IL 60542-2111 Ph: (306) 335-0540 |
| NPI Number | 1083444509 |
|---|---|
| Provider Enumeration Date | 08/07/2024 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 2567993892 |
|---|---|
| Medicare Enrollment ID | O20240927000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083444509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Marycarol Park |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700646262 PECOS PAC ID: 3476084708 Enrollment ID: I20240927000016 |
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