| Amy Ray, Ph.d., P.c. | |
|
350 Houbolt Rd Suite 202 Joliet IL 60431-8305 | |
| (815) 553-0788 | |
| (815) 553-0789 |
| Full Name | Amy Ray, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 350 Houbolt Rd, Joliet, Illinois |
| Authorized Official Name and Position | Amy Leandra Ray (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8155530788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Ray, Ph.d., P.c. 507 Birch Dr Shorewood IL 60404-9740 Ph: (815) 553-0788 | Amy Ray, Ph.d., P.c. 350 Houbolt Rd Suite 202 Joliet IL 60431-8305 Ph: (815) 553-0788 |
| NPI Number | 1043504657 |
|---|---|
| Provider Enumeration Date | 06/01/2011 |
| Last Update Date | 06/01/2011 |
| Medicare PECOS PAC ID | 4385818756 |
|---|---|
| Medicare Enrollment ID | O20111121000522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043504657 | NPI | - | NPPES |
| 1225368228 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 071005955 (Illinois) | Primary |
| Provider Name | Amy Leandra Ray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225368228 PECOS PAC ID: 1052449238 Enrollment ID: I20100508000025 |
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