| Paterno & Associates | |
|
36 Main St Park Ridge IL 60068-4059 | |
| (847) 692-6692 | |
| (847) 496-3388 |
| Full Name | Paterno & Associates |
|---|---|
| Speciality | Psychologist |
| Location | 36 Main St, Park Ridge, Illinois |
| Authorized Official Name and Position | Dathan A Paterno (OWNER) |
| Authorized Official Contact | 8476926692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paterno & Associates 36 Main St Park Ridge IL 60068-4059 Ph: (847) 692-6692 | Paterno & Associates 36 Main St Park Ridge IL 60068-4059 Ph: (847) 692-6692 |
| NPI Number | 1366557977 |
|---|---|
| Provider Enumeration Date | 08/21/2006 |
| Last Update Date | 12/01/2014 |
| Medicare PECOS PAC ID | 2860499738 |
|---|---|
| Medicare Enrollment ID | O20210506002175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366557977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071.006986 (Illinois) | Primary |
| Provider Name | Dathan A Paterno |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174608400 PECOS PAC ID: 7416954375 Enrollment ID: I20061107000307 |
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