PKC HEALTH SERVICE; NPI #1902658586

Contact Information

PKC HEALTH SERVICE

1521 OTTO BLVD
CHICAGO HEIGHTS, IL 60411-3875

Phone: 708-303-8816
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Brain Injury Medicine	2084P0301X	86	Physician/Neuropsychiatry
Art Therapist	221700000X
Behavior Analyst	103K00000X
Behavioral Neurology & Neuropsychiatry	2084B0040X
Brain Injury Medicine	2081P0301X	25	Physician/Physical Medicine and Rehabilitation
Clinical Neuropsychologist	103G00000X
Community/Behavioral Health	251S00000X
Drama Therapist	101200000X
In Home Supportive Care	253Z00000X
Mental Health	101YM0800X
Music Therapist	225A00000X
Physical Therapist	225100000X	65	Physical Therapist in Private Practice
Psychologist	103T00000X	62	Psychologist, Clinical
Recreation Therapist	225800000X
Speech-Language Pathologist	235Z00000X	15	Speech Language Pathologist

Indicates primary specialty

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NPI Profile & details for PKC HEALTH SERVICE

NPI #	`1902658586`
LBN Legal business name	PKC HEALTH SERVICE
Authorized official	LASHONDA CROCKETT - (PRESIDENT)
Entity	Organization
Organization subpart ¹	No
Enumeration date	04/04/2024
Last updated	09/26/2024 - More than a year ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PKC HEALTH SERVICE

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NPI Profile & details for PKC HEALTH SERVICE

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