ML Etchison and Associates, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071007027 Issued in IL

Legal business name

ML ETCHISON AND ASSOCIATES, INC.

Practice address

7350 W College Dr
Suite #106
Palos Heights, IL 60463-1149

Phone

(708) 269-3050

Fax

(708) 579-0169

NPI assigned

Apr 5, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mona Luan Etchison, PSY.D.NPI 1083700769

Title

President

Phone

(708) 269-3050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mona L Etchison, PSYD

  • Psychologist
  • Palos Heights, IL
  • NPI 1083700769
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1124446240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 N WAIOLA AVE",
            "city": "LA GRANGE PARK",
            "state": "IL",
            "postal_code": "605261451",
            "telephone_number": "708-269-3050",
            "fax_number": "708-579-0169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7350 W COLLEGE DR",
            "address_2": "SUITE #106",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631149",
            "telephone_number": "708-269-3050",
            "fax_number": "708-579-0169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ML ETCHISON AND ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-05",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "ETCHISON",
        "authorized_official_first_name": "MONA",
        "authorized_official_middle_name": "LUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-269-3050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071007027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Marie Miller, APRN,CNP
• Miracare Neuro Behavioral Health, PC
• Mubarak Mirjat, PT
• Kathleen Mitchell
• Chiedozie Mkpolulu, M.D.
• Ronald Mochizuki, M.D.
• James M Mohan, M.D.
• Latifa Mohsin
• Shakir Moiduddin, MD
• Terrence C Moisan, M.D.

• Psychologist in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.