| Paula P. Merucci, Llc | |
|
2530 Crawford Ave Ste 115 Evanston IL 60201-4954 | |
| (847) 859-6033 | |
| (847) 241-0305 |
| Full Name | Paula P. Merucci, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2530 Crawford Ave Ste 115, Evanston, Illinois |
| Authorized Official Name and Position | Paula P Merucci (OWNER) |
| Authorized Official Contact | 8478596033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paula P. Merucci, Llc 3425 Harrison St Evanston IL 60201-4953 Ph: (847) 859-6033 | Paula P. Merucci, Llc 2530 Crawford Ave Ste 115 Evanston IL 60201-4954 Ph: (847) 859-6033 |
| NPI Number | 1114434404 |
|---|---|
| Provider Enumeration Date | 01/08/2018 |
| Last Update Date | 01/08/2018 |
| Medicare PECOS PAC ID | 7012279870 |
|---|---|
| Medicare Enrollment ID | O20180315001250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114434404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 149017859 (Illinois) | Primary |
| Provider Name | Paula P Merucci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932542131 PECOS PAC ID: 5698070225 Enrollment ID: I20160219001068 |
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