Jason Peter Schallack MFA

NPI 1003104324 - Counselor - 101YM0800X

NPI Details
NPI 1003104324
Gender Male
Enumeration Date 07/20/2011
Last Updated 07/20/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
1414 MAIN ST
MELROSE PARK IL, 60160-3902, US
Phone (708) 681-0073
Fax (708) 681-3958
Business Location
539 BELLEFORTE AVE
OAK PARK IL, 60302-1623, US
Phone (708) 681-0073
Fax (708) 681-3958
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Mr. Jason Peter Schallack MFA NPI is 1003104324, taxonomy code is 101YM0800X Jason Peter Schallack MFA physically located at 1414 Main St, Melrose Park IL, 60160-3902. NPI Number Jason Peter Schallack MFA has the Individual type.

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1003104324 NPI number is provided on an as is basis without warranty of any kind. 1003104324 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Peter Schallack MFA are for informational purposes only.