| Advanced Psychiatric Services Sc | |
|
8311 Roosevelt Rd Forest Park IL 60130-2529 | |
| (708) 771-7000 | |
| Not Available |
| Full Name | Advanced Psychiatric Services Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8311 Roosevelt Rd, Forest Park, Illinois |
| Authorized Official Name and Position | Ralph Menezes (PROVIDER/OWNER) |
| Authorized Official Contact | 7084884968 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Psychiatric Services Sc Po Box 5800 River Forest IL 60305-5800 Ph: (708) 488-4968 | Advanced Psychiatric Services Sc 8311 Roosevelt Rd Forest Park IL 60130-2529 Ph: (708) 771-7000 |
| NPI Number | 1215982509 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 04/21/2015 |
| Medicare PECOS PAC ID | 0840202206 |
|---|---|
| Medicare Enrollment ID | O20060629000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215982509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036054796 (Illinois) | Primary |
| Provider Name | Ralph C Menezes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568417996 PECOS PAC ID: 2961398508 Enrollment ID: I20040223000430 |
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