| Aleksandr Dekhtyar Md Sc | |
|
614 Martin Ln Deerfield IL 60015-3633 | |
| (224) 805-6085 | |
| Not Available |
| Full Name | Aleksandr Dekhtyar Md Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 614 Martin Ln, Deerfield, Illinois |
| Authorized Official Name and Position | Aleksandr Dekhtyar (PROVIDER) |
| Authorized Official Contact | 2248056085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aleksandr Dekhtyar Md Sc 614 Martin Ln Deerfield IL 60015-3633 Ph: (224) 805-6085 | Aleksandr Dekhtyar Md Sc 614 Martin Ln Deerfield IL 60015-3633 Ph: (224) 805-6085 |
| NPI Number | 1801091582 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 10/16/2008 |
| Medicare PECOS PAC ID | 6406957919 |
|---|---|
| Medicare Enrollment ID | O20070727000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801091582 | NPI | - | NPPES |
| 036110249 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036110249 (Illinois) | Primary |
| Provider Name | Aleksandr Dekhtyar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851391155 PECOS PAC ID: 0648251405 Enrollment ID: I20040527000139 |
| Provider Name | Christopher Lynn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922479617 PECOS PAC ID: 4284915778 Enrollment ID: I20161221000090 |
| Provider Name | Joseph Z Rahman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497259527 PECOS PAC ID: 9537422720 Enrollment ID: I20180423001576 |
| Provider Name | Joseph A Spagnola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649760083 PECOS PAC ID: 9436408150 Enrollment ID: I20180814001031 |
| Provider Name | John Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649762352 PECOS PAC ID: 2264783778 Enrollment ID: I20180922000056 |
| Provider Name | Maureen Pascual Raiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306559604 PECOS PAC ID: 3779947411 Enrollment ID: I20230913001784 |
| Provider Name | Noel Tapia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871233841 PECOS PAC ID: 2860847407 Enrollment ID: I20231017001591 |
| Provider Name | Clarice Marie La France |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245564699 PECOS PAC ID: 6901256205 Enrollment ID: I20231228003625 |
| Provider Name | Phuong Thao Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538870787 PECOS PAC ID: 0547611105 Enrollment ID: I20240108004295 |
| Provider Name | Tessa Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518656479 PECOS PAC ID: 7517310204 Enrollment ID: I20240130000651 |
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