Amy Fayazrad & Associates, Pc | |
3633 W Lake Ave Ste 306 Glenview IL 60026-5803 | |
(760) 831-1191 | |
Not Available |
Full Name | Amy Fayazrad & Associates, Pc |
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Speciality | Psychologist |
Location | 3633 W Lake Ave Ste 306, Glenview, Illinois |
Authorized Official Name and Position | Amy Fayazrad Fayazrad (PRESIDENT) |
Authorized Official Contact | 7608311191 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Amy Fayazrad & Associates, Pc 4137 N Meade Ave Chicago IL 60634-1506 Ph: () - | Amy Fayazrad & Associates, Pc 3633 W Lake Ave Ste 306 Glenview IL 60026-5803 Ph: (760) 831-1191 |
NPI Number | 1184147647 |
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Provider Enumeration Date | 07/17/2017 |
Last Update Date | 07/17/2017 |
Medicare PECOS PAC ID | 2163778960 |
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Medicare Enrollment ID | O20180710001193 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184147647 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Amy D Fayazrad |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1043440910 PECOS PAC ID: 2668775479 Enrollment ID: I20160127002297 |
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