Organization
HERITAGE PROFESSIONAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACI PAVLIK (OFFICE MANAGER)
(630) 325-5300
Entity
Organization
Contact information
Practice address
126 E CHESTNUT ST, RCCW THIRD FLOOR, CHICAGO, IL 60611-2014
(312) 787-8425
Mailing address
120 E OGDEN AVE, SUITE 220, HINSDALE, IL 60521-3542
(630) 325-5300
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033244173
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/02/2015
Last updated
11/02/2015
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