Mr Douglas K Derhodes, LCSW | |
822 Hillgrove Ave, Second Floor, Western Springs, IL 60558-1464 | |
(773) 969-6864 | |
(708) 300-9491 |
Full Name | Mr Douglas K Derhodes |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 822 Hillgrove Ave, Western Springs, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568695385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.013400 (Illinois) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20220414000139 |
Mailing Address | Practice Location Address |
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Mr Douglas K Derhodes, LCSW 5351 N Ashland Ave, Unit 1, Chicago, IL 60640-2053 Ph: (773) 896-5876 | Mr Douglas K Derhodes, LCSW 822 Hillgrove Ave, Second Floor, Western Springs, IL 60558-1464 Ph: (773) 969-6864 |
Amy Maura Lee, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 822 Hillgrove Ave, Western Springs, IL 60558 Phone: 708-246-4277 | |
Carolyn Bonistalli, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4806 Fair Elms Ave, Western Springs, IL 60558 Phone: 708-732-0654 | |
Mrs. Brooke Greco, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4727 Howard Ave, Western Springs, IL 60558 Phone: 847-917-1185 | |
Ms. Julie Fallon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4839 Wolf Rd, Western Springs, IL 60558 Phone: 708-829-1869 | |
Cecilia Yasmine Rivera, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 822 Hillgrove Ave Ste 2, Western Springs, IL 60558 Phone: 872-254-3804 | |
Cory James Grad, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1023 Burlington Ave, Western Springs, IL 60558 Phone: 708-995-3680 | |
Mrs. Geri Ann Silic, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 822 Hillgrove Ave, Western Springs, IL 60558 Phone: 708-246-4277 |