Provider Demographics
NPI:1124699038
Name:M PACHAN PHD PLLC
Entity type:Organization
Organization Name:M PACHAN PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PACHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:312-342-2894
Mailing Address - Street 1:3317 W LE MOYNE ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-2452
Mailing Address - Country:US
Mailing Address - Phone:312-342-2894
Mailing Address - Fax:
Practice Address - Street 1:3317 W LE MOYNE ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-2452
Practice Address - Country:US
Practice Address - Phone:312-342-2894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty