| Patricia A Mckenna Phd Inc. | |
|
645 N Michigan Ave Ste 500 Chicago IL 60611-2881 | |
| (312) 787-6173 | |
| Not Available |
| Full Name | Patricia A Mckenna Phd Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 645 N Michigan Ave Ste 500, Chicago, Illinois |
| Authorized Official Name and Position | Patricia Mckenna (PRESIDENT) |
| Authorized Official Contact | 3127876173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Patricia A Mckenna Phd Inc. 645 N Michigan Ave Ste 500 Chicago IL 60611-2881 Ph: (312) 787-6173 | Patricia A Mckenna Phd Inc. 645 N Michigan Ave Ste 500 Chicago IL 60611-2881 Ph: (312) 787-6173 |
| NPI Number | 1992118574 |
|---|---|
| Provider Enumeration Date | 06/11/2014 |
| Last Update Date | 05/19/2020 |
| Certification Date | 05/19/2020 |
| Medicare PECOS PAC ID | 5092931691 |
|---|---|
| Medicare Enrollment ID | O20140716001563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992118574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 071006109 (Illinois) | Primary |
| Provider Name | Patricia A Mckenna |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578654414 PECOS PAC ID: 4587665682 Enrollment ID: I20070116000181 |
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