Provider Demographics
NPI:1740173699
Name:PJG AND ASSOCIATES
Entity type:Organization
Organization Name:PJG AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MHT
Authorized Official - Phone:515-519-2090
Mailing Address - Street 1:4117 N LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-4935
Mailing Address - Country:US
Mailing Address - Phone:515-519-2090
Mailing Address - Fax:
Practice Address - Street 1:1600 GOLF RD STE 1200
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-4229
Practice Address - Country:US
Practice Address - Phone:515-519-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health