Organization
7739956300
Active
Other names
TCA HEALTH CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARQUETTA D HALL CPCS (BILLING CODING SPECIALIST)
(773) 995-6300
Entity
Organization
Contact information
Practice address
1029 E 130TH ST, CHICAGO, IL 60628-6908
(773) 995-6300
(773) 995-6192
Mailing address
1029 E.130TH STREET, CHICAGO, IL 60628
(773) 995-6300
(773) 995-6192
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149018713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149018713
149018713
IL
Enumeration date
01/13/2017
Last updated
01/13/2017
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