Correa-Illidge, Patricia S
Correa-Illidge, Patricia S is an individual health care provider with primary practice located at 4510 Frankford Ave 2Nd Floor, Philadelphia PA 19124-3602. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Correa-Illidge, Patricia S can be contacted via phone (215) 831-9882.Contact Information
Primary practice address
4510 Frankford Ave 2Nd Floor
Philadelphia PA 19124-3602
Phone: (215) 831-9882
Fax: (215) 831-9887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | SW008617L | Pennsylvania |
Profile Details
| NPI number | 1598715179 |
|---|---|
| LBN Legal business name | Correa-Illidge, Patricia S |
| Credentials | LSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Nov 1st, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598715179 | NPPES |
| Pennsylvania | Other | 001663401 | INDEPENDENCE BLUE CROSS |
| Pennsylvania | Other | 455792000 | INDEPENDENCE BLUE CROSS |
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