Central Professional Group
Psychiatry & Neurology, Psychiatry in Joliet, IL. Organization (NPI-2).
NPI number1255453056
StatusActive
Last updated in NPPESApr 28, 2009
Details
- NPI
- 1255453056
- Entity type
- Organization (NPI-2)
- Legal business name
- Central Professional Group
- Organization subpart
- No
- Enumeration date
- Apr 4, 2007
- Last updated
- Apr 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 1041C0700X | Social Worker, Clinical | – | – |
Practice location
210 N Hammes AveSuite 103
Joliet, IL 60435-6680
Phone 815-725-6511 · Fax 815-725-7166
Mailing address
210 N Hammes AveSuite 103
Joliet, IL 60435-6680
Phone 815-725-6511 · Fax 815-725-7166
Authorized official
Dawn Benevides
Billing Supervisor
8157256511
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