Poletti, Jorge R
Poletti, Jorge R is an sole proprietor health care provider with primary practice located at 1414 Main St , Melrose Park IL 60160-3902. He recently has only one registered license in Behavioral Health & Social Service Providers / Counselor, which is considered as his primary health care specialty. Poletti, Jorge R can be contacted via phone (708) 681-0073.Contact Information
Primary practice address
1414 Main St
Melrose Park IL 60160-3902
Phone: (708) 681-0073
Fax: (708) 681-3958
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1174801567 |
|---|---|
| LBN Legal business name | Poletti, Jorge R |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 2nd, 2011 |
| Last updated | Aug 2nd, 2011 - about 14 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 | 1174801567 | NPPES |
| Illinois | MEDICAID | 987654321 |
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