| Proviso Public Partnership | |
|
4565 Harrison St Fl 3 Hillside IL 60162-1617 | |
| (708) 240-4435 | |
| (708) 449-6421 |
| Full Name | Proviso Public Partnership |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4565 Harrison St Fl 3, Hillside, Illinois |
| Authorized Official Name and Position | Kate Minella (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7082404435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Proviso Public Partnership 4565 Harrison St Fl 3 Hillside IL 60162-1617 Ph: (708) 240-4435 | Proviso Public Partnership 4565 Harrison St Fl 3 Hillside IL 60162-1617 Ph: (708) 240-4435 |
| NPI Number | 1801304142 |
|---|---|
| Provider Enumeration Date | 01/22/2018 |
| Last Update Date | 07/22/2021 |
| Certification Date | 07/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801304142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Aspire Of Illinois Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1815 S Wolf Rd, Hillside, IL 60162 Phone: 708-547-3550 |