Basic Information
| Provider Information | |||||||||
| NPI: | 1164553566 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PROFESSIONAL CONSULTATIONS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 745 S 8TH ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | WEST DUNDEE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601182108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004287260 | ||||||||
| FaxNumber: | 8474287269 | ||||||||
| Practice Location | |||||||||
| Address1: | 745 S 8TH ST | ||||||||
| Address2: | |||||||||
| City: | WEST DUNDEE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601182108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8004287260 | ||||||||
| FaxNumber: | 8474287269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2007 | ||||||||
| LastUpdateDate: | 08/16/2013 | ||||||||
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| AuthorizedOfficialLastName: | MILLIMAN | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT & CEO | ||||||||
| AuthorizedOfficialTelephone: | 8004287260 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | A01600006A | IL | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 251S00000X | A01600006A | IL | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 299518 | 01 | IL | VALUE OPTIONS | OTHER | 900006119 | 01 | IL | APS HEALTHCARE | OTHER | 000263509001 | 01 | IL | UNITED BEHAVIORAL HEALTH | OTHER | 5382205 | 01 | IL | AETNA | OTHER | 242687 | 01 | IL | MANAGED HEALTH NETWORK | OTHER | 4515298 | 01 | IL | BLUE CROSS BLUE SHIELD OF ILLINOIS | OTHER | 492190-000 | 01 | IL | MAGELLAN | OTHER |