| Vicki L Eaton Pc | |
|
825 W Jerome Cir Mesa AZ 85210-5939 | |
| (480) 603-5360 | |
| Not Available |
| Full Name | Vicki L Eaton Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 825 W Jerome Cir, Mesa, Arizona |
| Authorized Official Name and Position | Vicki Lee Eaton (PRESIDENT) |
| Authorized Official Contact | 4806035360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicki L Eaton Pc 1501 Coventry Rd Schaumburg IL 60195-3229 Ph: (847) 781-1407 | Vicki L Eaton Pc 825 W Jerome Cir Mesa AZ 85210-5939 Ph: (480) 603-5360 |
| NPI Number | 1699954891 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 04/08/2020 |
| Certification Date | 04/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699954891 | NPI | - | NPPES |
| 01626654 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149-005721 (Illinois) | Primary |
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