Organization
MJ MENDIZABAL PA-C MMS, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JEAN MENDIZABAL PA-C (OWNER)
(773) 984-1494
Entity
Organization
Contact information
Practice address
422 N NORTHWEST HWY STE B2, PARK RIDGE, IL 60068-3272
(773) 984-1494
(773) 904-1919
Mailing address
422 N NORTHWEST HWY STE B2, PARK RIDGE, IL 60068-3272
(773) 984-1494
(773) 904-1919
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902989908
—
IL
Enumeration date
01/07/2026
Last updated
01/07/2026
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