| Ascension Health | |
| 
					1414 Main St Melrose Park IL 60160-3902  | |
| (708) 681-0073 | |
| Not Available | 
| Full Name | Ascension Health | 
|---|---|
| Speciality | Behavior Technician | 
| Location | 1414 Main St, Melrose Park, Illinois | 
| Authorized Official Name and Position | Normita Nicole Donaldson (BEHAVIORAL HEALTH TECH) | 
| Authorized Official Contact | 7738424042 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ascension Health 1414 Main St Melrose Park IL 60160-3902 Ph: (708) 681-0073  | Ascension Health 1414 Main St Melrose Park IL 60160-3902 Ph: (708) 681-0073  | 
| NPI Number | 1851077325 | 
|---|---|
| Provider Enumeration Date | 06/27/2023 | 
| Last Update Date | 06/27/2023 | 
| Certification Date | 06/27/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1851077325 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary | 
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