312 Psych Services Pllc | |
226 N Clinton St Apt 321 Chicago IL 60661-1184 | |
(773) 759-2036 | |
Not Available |
Full Name | 312 Psych Services Pllc |
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Speciality | Clinic/Center |
Location | 226 N Clinton St Apt 321, Chicago, Illinois |
Authorized Official Name and Position | Alicia Ali (OWNER) |
Authorized Official Contact | 3122483655 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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312 Psych Services Pllc 917 W Washington Blvd Unit 272 Chicago IL 60607-2203 Ph: (312) 248-3655 | 312 Psych Services Pllc 226 N Clinton St Apt 321 Chicago IL 60661-1184 Ph: (773) 759-2036 |
NPI Number | 1538850276 |
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Provider Enumeration Date | 05/15/2023 |
Last Update Date | 05/15/2023 |
Certification Date | 05/15/2023 |
Medicare PECOS PAC ID | 0547623142 |
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Medicare Enrollment ID | O20230830001247 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538850276 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Alicia Ali |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1306221338 PECOS PAC ID: 9436498094 Enrollment ID: I20190227000600 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
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K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
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Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
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Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |