| Aeries Healthcare Of Illinois Physician Group | |
|
8311 W Roosevelt Rd Forest Park IL 60130 | |
| (708) 209-4150 | |
| Not Available |
| Full Name | Aeries Healthcare Of Illinois Physician Group |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 8311 W Roosevelt Rd, Forest Park, Illinois |
| Authorized Official Name and Position | Michael Nelson (CFO) |
| Authorized Official Contact | 7082094156 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aeries Healthcare Of Illinois Physician Group Po Box 840936 Dallas TX 72584 Ph: (708) 209-4152 | Aeries Healthcare Of Illinois Physician Group 8311 W Roosevelt Rd Forest Park IL 60130 Ph: (708) 209-4150 |
| NPI Number | 1083841076 |
|---|---|
| Provider Enumeration Date | 06/17/2009 |
| Last Update Date | 06/17/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083841076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (Illinois) | Primary |
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