MARY MIKA (NPI# 1487970505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487970505 |
| Entity Type | Individual |
| Full Name | MARY MIKA |
| Credential | LCPC |
| Practice Address |
13011 S 104th Ave Suite 200 Palos Park IL 60464-1506 |
| Practice Telephone | 7084483300 |
| Practice Fax Number | 7084486972 |
| Mailing Telephone | 7084483300 |
| Mailing Fax Number | 7084486972 |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2010-11-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
180.007345 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 180.007345 | 01 |
| Street Address |
13011 S 104TH AVE SUITE 200 |
| City | PALOS PARK |
| State | IL |
| Zip Code | 60464-1506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508810086 | Heart Care Centers of Illinois, S.c. | Internal Medicine | 13011 S 104th Ave, Suite 100, Palos Park, IL 60464-1506 | 2006-05-20 |
| 1437714383 | Jillian Meaney | Physician Assistant | 13011 S 104th Ave, Palos Park, IL 60464-1506 | 2019-05-07 |
| 1396284949 | Samantha Mary Brown | Physician Assistant | 13011 S 104th Ave, Suite 100, Palos Park, IL 60464-1506 | 2017-02-15 |
| 1750767604 | Jacqueline Lee Marchbank | Nurse Practitioner | 13011 S 104th Ave, Suite 100, Palos Park, IL 60464-1506 | 2015-08-03 |
| 1497144075 | Yvette Lombardi | Acupuncturist | 13011 S 104th Ave, Palos Park, IL 60464-1506 | 2015-01-20 |
| 1104238534 | Heart Care Centers of Illinois, Sc | Internal Medicine | 13011 S 104th Ave, Palos Park, IL 60464-1506 | 2014-05-20 |
| 1316288392 | Kemet Chiropractic & Wellness, S.c. | Chiropractor | 13011 S 104th Ave, 207, Palos Park, IL 60464-1506 | 2013-03-15 |
| 1093067233 | Palos Pediatric Associates, PC | Specialist | 13011 S 104th Ave, Ste 203, Palos Park, IL 60464-1506 | 2012-10-11 |
| 1962797142 | New Beginnings Home Health Care, Inc. | Home Health | 13011 S 104th Ave, Suite 205, Palos Park, IL 60464-1506 | 2011-06-15 |
| 1083915474 | Brian Edwin Bailey | Dentist | 13011 S 104th Ave, Suite # 209, Palos Park, IL 60464-1506 | 2010-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518456102 | Lisa Kay York | Behavior Technician | 8207 Il-83, Palos Park, IL 60464 | 2018-05-09 |
| 1972000479 | Elizabeth Faye Putman | Physical Therapy Assistant | 10300 Village Cir Dr, Peace Village, Palos Park, IL 60464 | 2018-04-11 |
| 1730446998 | Steven Jay Quinn | Internal Medicine | 11900 Southwest Hwy Ste 101, Palos Park, IL 60464 | 2012-04-12 |
| 1376677625 | Palos C C S D 118 | Local Education Agency (LEA) | 8800 West 119th Street, Palos Park, IL 60464 | 2007-03-16 |
| 1730233297 | Rajitha Lakshmi Avva | Psychiatry & Neurology | Palos Behavioral Health, 13011 S 104th Ave, Palos Park, IL 60464 | 2007-01-22 |
| 1487714671 | Maple Park Dental Care, P.C. | Dentist | 1048 104th Street, #108, Naperville, IL 60464 | 2006-12-11 |
| 1912065418 | David M Kozal | Dentist | 11900 Sw Hwy, Palos Park, IL 60464 | 2006-12-05 |
| 1598845422 | Michele Antoinette Nealon Woods | Psychologist | Palos Behavioral Health Professionals, 103011 S 104th Ave Suite 200, Palos Park, IL 60464 | 2006-10-16 |
| 1679683585 | Linda G Baer | Psychologist | 13011 104th Ave, Suite 200, Palos Park, IL 60464 | 2006-08-30 |
| 1578507430 | Hugh Michael Oneill | Family Medicine | 14741 Ravinia Ave, Orland Park, IL 60464 | 2006-06-15 |
| Find all providers in zip 60464 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326399015 | Sue Ellen Parker | Counselor | 12503 S 79th Ave, Palos Park, IL 60464-1929 | 2012-09-21 |
| 1356697239 | Saulena Antanaviciene | Counselor | 12727 S 82nd Ct, Palos Park, IL 60464-2018 | 2012-07-30 |
| 1437450541 | Dwonna Denise Thompson | Counselor | 13011 S 104th Ave, Palos Park, IL 60464-1506 | 2010-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457952194 | Hope Kravetz | Counselor | 815 Belinder Ln, Schaumburg, IL 60173-6360 | 2020-11-07 |
| 1609477579 | Shantrell Patrice Sutton | Counselor | 5042 W Erie St, Chicago, IL 60644-1604 | 2020-11-05 |
| 1073114591 | Alternative Schools Network | Counselor | 1807 W Sunnyside Ave, Chicago, IL 60640-5898 | 2020-11-02 |
| 1992306518 | Gravity and Grace Psychotherapy, Pllc | Counselor | 1305 S Michigan Ave Apt 602, Chicago, IL 60605-3398 | 2020-11-02 |
| 1811597263 | April Wilburne | Counselor | 804 E 54th St Apt 3, Chicago, IL 60615-4972 | 2020-10-27 |
| 1043810393 | Pamela Kranyak | Counselor | 30 N Michigan Ave Ste 925, Chicago, IL 60602-3463 | 2020-10-27 |
| 1831798404 | Erin Frasco | Counselor | 622 Davis St # 200, Evanston, IL 60201-4491 | 2020-10-23 |
| 1568061224 | Alternative Counseling Solutions, Inc | Counselor | 6469 E Mccormick Rd, Stillman Valley, IL 61084-9736 | 2020-10-22 |
| 1396344537 | Janet M Wills | Counselor | 223 N Prospect Ave, Streamwood, IL 60107-4103 | 2020-10-19 |
| 1225637614 | Sharice Ellenwood | Counselor | 1087 N Village Dr, Round Lake Beach, IL 60073 | 2020-10-18 |
| Find all providers with the same taxonomy | ||||
| City | PALOS PARK |
| Zip Code | 60464 |
Please comment or provide details below to improve the information on MARY MIKA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.