Provider Demographics
NPI:1548777303
Name:COUNSELING ON WHEELS
Entity Type:Organization
Organization Name:COUNSELING ON WHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SKIBA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-721-8442
Mailing Address - Street 1:10655 YELLOWSTONE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-8171
Mailing Address - Country:US
Mailing Address - Phone:708-721-8442
Mailing Address - Fax:
Practice Address - Street 1:121 S WILKE RD STE 205
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1525
Practice Address - Country:US
Practice Address - Phone:708-721-8442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-03
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007241261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health