Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mpac Phc of Il PC

Organization Clinical Social Worker · NPI 1396402129

Mpac Phc of Il PC is a Clinical Social Worker in Chicago, Illinois. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 N La Salle St Ste 1550
Chicago, IL 60601-1034
Phone: (888) 705-8722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X
Clinical Social Worker Taxonomy 1041C0700X

Record details

NPI number1396402129
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Martinez — Ceo · (888) 660-4425
NPI enumeratedNovember 29, 2021
Last updated in NPPESDecember 10, 2021
Certification dateDecember 10, 2021
Mailing addressPo Box 5031 Pmb 17336, Evanston, IL 60204-5031

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