| Pathway Provider Services Pc | |
|
810 Harrison St Oak Park IL 60304 | |
| (708) 445-9330 | |
| Not Available |
| Full Name | Pathway Provider Services Pc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 810 Harrison St, Oak Park, Illinois |
| Authorized Official Name and Position | James A Quandt (PRESIDENT) |
| Authorized Official Contact | 7083830065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pathway Provider Services Pc 810 Harrison St Oak Park IL 60304 Ph: (708) 383-0065 | Pathway Provider Services Pc 810 Harrison St Oak Park IL 60304 Ph: (708) 445-9330 |
| NPI Number | 1366575623 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366575623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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