Provider Demographics
NPI:1013199603
Name:PARA, CAROLYN M
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:M
Last Name:PARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 ARCHER AVENUE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:IL
Mailing Address - Zip Code:60501
Mailing Address - Country:US
Mailing Address - Phone:708-458-4515
Mailing Address - Fax:708-458-9177
Practice Address - Street 1:7420 ARCHER AVENUE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:IL
Practice Address - Zip Code:60501
Practice Address - Country:US
Practice Address - Phone:708-458-4515
Practice Address - Fax:708-458-9177
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health