Anne Chodzko Pc | |
636 Church St Suite 701 Evanston IL 60201-4508 | |
(847) 926-9487 | |
Not Available |
Full Name | Anne Chodzko Pc |
---|---|
Speciality | Psychologist |
Location | 636 Church St, Evanston, Illinois |
Authorized Official Name and Position | Anne Chodzko (CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 8474330810 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Anne Chodzko Pc 991 Deerfield Rd Highland Park IL 60035-3569 Ph: (847) 433-0810 | Anne Chodzko Pc 636 Church St Suite 701 Evanston IL 60201-4508 Ph: (847) 926-9487 |
NPI Number | 1679602809 |
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Provider Enumeration Date | 03/05/2007 |
Last Update Date | 12/07/2007 |
Medicare PECOS PAC ID | 2961425822 |
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Medicare Enrollment ID | O20060106000400 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679602809 | NPI | - | NPPES |
P00276349 | Other | IL | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (Illinois) | Primary |
Provider Name | Anne C Chodzko |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1356316939 PECOS PAC ID: 0749203602 Enrollment ID: I20060106000438 |
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