| Kevin Siscoe, LCPC | |
|
6615 N Big Hollow Rd, Peoria, IL 61615-2450 | |
| (309) 692-6622 | |
| (309) 692-6952 |
| Full Name | Kevin Siscoe |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 6615 N Big Hollow Rd, Peoria, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043632524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180008974 (Illinois) | Primary |
| Entity Name | The Antioch Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801993142 PECOS PAC ID: 8224920764 Enrollment ID: O20040329000526 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Siscoe, LCPC 6615 N Big Hollow Rd, Peoria, IL 61615-2450 Ph: (309) 692-6622 | Kevin Siscoe, LCPC 6615 N Big Hollow Rd, Peoria, IL 61615-2450 Ph: (309) 692-6622 |
Ms. Debra Fay Disney, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7617 N Villa Wood Ln, Peoria, IL 61614 Phone: 309-693-8200 | |
Julie Kristine Peters, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2000 W Pioneer Pkwy Ste 14, Peoria, IL 61615 Phone: 309-550-1001 | |
Mrs. Linda L Zears, MS LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3716 W Brighton Ave, Peoria, IL 61615 Phone: 309-692-7755 Fax: 309-692-2262 | |
Mrs. Tamara Marie Lott, LCPC, CRC Counselor Medicare: Medicare Enrolled Practice Location: 515 Ne Glen Oak Ave Ste 101, Osf Saint Francis Medical Center, Peoria, IL 61603 Phone: 309-655-7795 Fax: 309-655-4609 | |
Dr. Michael S Shear, PSY.D. Counselor Medicare: Not Enrolled in Medicare Practice Location: 456 Fulton St, Suite 101, Peoria, IL 61602 Phone: 309-673-9385 Fax: 309-673-9446 | |
Mrs. Sandra Susan Cross, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 2522 W Stronehenge Ct, Peoria, IL 61615 Phone: 309-264-9517 | |
Mrs. Donna Jaree Brooks, MA LCPC Counselor Medicare: Medicare Enrolled Practice Location: 3716 W Brighton Ave, Peoria, IL 61615 Phone: 309-692-7755 Fax: 309-692-2262 |