Provider Demographics
NPI:1316547334
Name:M C PURRI INC
Entity Type:Organization
Organization Name:M C PURRI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PURRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-676-4688
Mailing Address - Street 1:24012 W RENWICK RD
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-8731
Mailing Address - Country:US
Mailing Address - Phone:815-676-4688
Mailing Address - Fax:
Practice Address - Street 1:24012 W RENWICK RD STE 204
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-8733
Practice Address - Country:US
Practice Address - Phone:815-676-4688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty