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Organization
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Active
Organization
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEARL D BALLARD (REGISTERED NURSE)
(708) 267-3088
Entity
Organization
Contact information
Practice address
14714 STATE ST, DOLTON, IL 60419-1517
(708) 267-3088
Mailing address
14714 STATE ST, DOLTON, IL 60419-1517
(708) 267-3088
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
041296287
IL
Other
Enumeration date
03/30/2017
Last updated
03/30/2017
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