Mr Benjamin Severance, | |
1305 E Indian Trl, Aurora, IL 60505-1600 | |
(630) 966-4297 | |
Not Available |
Full Name | Mr Benjamin Severance |
---|---|
Gender | Male |
Speciality | Clinical Social Worker |
Experience | 11 Years |
Location | 1305 E Indian Trl, Aurora, Illinois |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902178379 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Vitae Health Of Illinois Llc | 2365798410 | 149 |
Entity Name | Vitae Health Of Illinois Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174013452 PECOS PAC ID: 2365798410 Enrollment ID: O20180703002838 |
Mailing Address | Practice Location Address |
---|---|
Mr Benjamin Severance, 1305 E Indian Trl, Aurora, IL 60505-1600 Ph: (630) 966-4297 | Mr Benjamin Severance, 1305 E Indian Trl, Aurora, IL 60505-1600 Ph: (630) 966-4297 |
Ms. Cheryl Banasiak, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1230 N Highland Ave, Aurora, IL 60506 Phone: 630-966-4305 | |
Kiana Hickman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1630 Plum St, Aurora, IL 60506 Phone: 630-966-4475 | |
Dina Tate, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 400 Mercy Ln, Aurora, IL 60506 Phone: 630-966-7400 | |
Ana Karen Ruiz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1325 N Highland Ave, Aurora, IL 60506 Phone: 630-906-7015 Fax: 630-801-2626 | |
Lasdavahn Ashley Vongphakdy, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1230 N Highland Ave, Aurora, IL 60506 Phone: 630-966-4331 | |
Rosa Garcia, Counselor Medicare: Not Enrolled in Medicare Practice Location: 309 New Indian Trail Ct, Aurora, IL 60506 Phone: 630-966-4301 | |
Shenna Hill, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1230 N Highland Ave, Aurora, IL 60506 Phone: 630-966-4000 |