| Suburban Clinical Services P C | |
|
222 N Marion St Oak Park IL 60302-1968 | |
| (708) 795-4747 | |
| (708) 383-2578 |
| Full Name | Suburban Clinical Services P C |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 222 N Marion St, Oak Park, Illinois |
| Authorized Official Name and Position | Gulliume Moor (OWNER) |
| Authorized Official Contact | 7087954747 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Suburban Clinical Services P C Po Box 3157 Oak Park IL 60303-3157 Ph: (708) 795-4747 | Suburban Clinical Services P C 222 N Marion St Oak Park IL 60302-1968 Ph: (708) 795-4747 |
| NPI Number | 1801912019 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 11/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801912019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071002653 (Illinois) | Primary |
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