Provider Demographics
NPI:1487793840
Name:PATHWAYS FAMILY THERAPY, P.C.
Entity type:Organization
Organization Name:PATHWAYS FAMILY THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHILPA
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOBALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:630-415-2088
Mailing Address - Street 1:1431 HUNTER CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8383
Mailing Address - Country:US
Mailing Address - Phone:630-415-2088
Mailing Address - Fax:
Practice Address - Street 1:121 S WILKE RD
Practice Address - Street 2:SUITE 234
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1533
Practice Address - Country:US
Practice Address - Phone:630-415-2088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490098421041C0700X
IL166000560106H00000X
IL180007406101YP2500X
IL166000558106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001633169OtherBCBS PROVIDER NUMBER