Provider Demographics
NPI:1457681090
Name:MCKENNA QUALITY THERAPEUTIC SERVICES, P.C.
Entity Type:Organization
Organization Name:MCKENNA QUALITY THERAPEUTIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/CLINICAL CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:312-714-5154
Mailing Address - Street 1:3517 W PALMER ST # 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-3519
Mailing Address - Country:US
Mailing Address - Phone:312-714-5154
Mailing Address - Fax:312-854-2850
Practice Address - Street 1:3517 W PALMER ST # 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-3519
Practice Address - Country:US
Practice Address - Phone:312-714-5154
Practice Address - Fax:312-854-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0126011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty