Organization
NORTH PARK CLINIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DICKIE KAY M.D. (OWNER)
(847) 692-7101
Entity
Organization
Contact information
Practice address
444 N NORTHWEST HWY STE 170, PARK RIDGE, IL 60068-6402
(847) 692-7101
(847) 692-7126
Mailing address
444 N NORTHWEST HWY STE 170, PARK RIDGE, IL 60068-6402
(847) 692-7101
(847) 692-7126
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001615772
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
09/20/2006
Last updated
08/22/2020
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