PKC HEALTH SERVICE NPI 1902658586

NPI Information

  • NPI: 1902658586
  • Provider Name: PKC HEALTH SERVICE
  • Classification: Psychiatry & Neurology - 2084P0301X
  • Specialization: Brain Injury Medicine
  • Entity Type: Organization
  • Doing Business As: PKC HEALTH SERVICE
  • Address: 1521 OTTO BLVD
    CHICAGO HEIGHTS, IL
    ZIP 60411
  • Phone: (708) 303-8816

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NPI Details

PKC HEALTH SERVICE is a brain injury medicine psychiatry neurology in Chicago Heights, IL. The provider is a Brain Injury Medicine physician specializes in disorders of brain function due to injury and disease. These disorders encompass a range of medical, physical, neurologic, cognitive, sensory, and behavioral disorders that result in psychosocial, educational, and vocational consequences. PKC HEALTH SERVICE NPI is 1902658586. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Pkc Health Service.

The provider's business location address is:

1521 OTTO BLVD
CHICAGO HEIGHTS, IL
ZIP 60411-875
Phone: (708) 303-8816

The provider's authorized official is Lashonda Crockett .
The authorized official title is President and has the following contact phone number (708) 303-8816.

The enumeration date for this NPI number is 4/4/2024 and was last updated on 9/26/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101200000XDrama TherapistNo
2101YM0800XCounselorMental HealthNo
3103G00000XClinical NeuropsychologistNo
4103K00000XBehavior AnalystNo
5103T00000XPsychologistNo
62081P0301XPhysical Medicine & RehabilitationBrain Injury MedicineNo
72084B0040XPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryNo
82084P0301XPsychiatry & NeurologyBrain Injury MedicineYes
9221700000XArt TherapistNo
10225100000XPhysical TherapistNo
11225800000XRecreation TherapistNo
12225A00000XMusic TherapistNo
13235Z00000XSpeech-Language PathologistNo
14251S00000XCommunity/Behavioral HealthNo
15253Z00000XIn Home Supportive CareNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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