| Parent First Empowerment Consultation Team | |
|
21w250 Audubon Rd Lombard IL 60148-5205 | |
| (309) 242-2172 | |
| Not Available |
| Full Name | Parent First Empowerment Consultation Team |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 21w250 Audubon Rd, Lombard, Illinois |
| Authorized Official Name and Position | Nicole Wiesman (OWNER) |
| Authorized Official Contact | 3092422172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Parent First Empowerment Consultation Team 21w250 Audubon Rd Lombard IL 60148-5205 Ph: (309) 242-2172 | Parent First Empowerment Consultation Team 21w250 Audubon Rd Lombard IL 60148-5205 Ph: (309) 242-2172 |
| NPI Number | 1013767680 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013767680 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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