| Center To Awaken Kindness, Division Of Penny & Bill Company | |
|
3604 Sunnyside Ave Brookfield IL 60513-1630 | |
| (708) 387-7986 | |
| Not Available |
| Full Name | Center To Awaken Kindness, Division Of Penny & Bill Company |
|---|---|
| Speciality | Social Worker |
| Location | 3604 Sunnyside Ave, Brookfield, Illinois |
| Authorized Official Name and Position | William G Ressl (VICE-PRESIDENT) |
| Authorized Official Contact | 7083877986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center To Awaken Kindness, Division Of Penny & Bill Company 3604 Sunnyside Ave Brookfield IL 60513-1630 Ph: (708) 387-7986 | Center To Awaken Kindness, Division Of Penny & Bill Company 3604 Sunnyside Ave Brookfield IL 60513-1630 Ph: (708) 387-7986 |
| NPI Number | 1497486112 |
|---|---|
| Provider Enumeration Date | 06/22/2022 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Medicare PECOS PAC ID | 4981086311 |
|---|---|
| Medicare Enrollment ID | O20220802002760 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497486112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Penny L. Taylor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033857958 PECOS PAC ID: 5890177224 Enrollment ID: I20220802003014 |
| Provider Name | William G Ressl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326785973 PECOS PAC ID: 0143602581 Enrollment ID: I20220829001454 |
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