| Ascension Behavioral Healthcare | |
|
1005 E 61st St Chicago IL 60637-2713 | |
| (708) 439-2883 | |
| (312) 328-7808 |
| Full Name | Ascension Behavioral Healthcare |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1005 E 61st St, Chicago, Illinois |
| Authorized Official Name and Position | Min Wang (BOARD CERTIFIED PSYCHIATRIST) |
| Authorized Official Contact | 7084392883 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Behavioral Healthcare 1005 E 61st St Chicago IL 60637-2713 Ph: (708) 439-2883 | Ascension Behavioral Healthcare 1005 E 61st St Chicago IL 60637-2713 Ph: (708) 439-2883 |
| NPI Number | 1922419365 |
|---|---|
| Provider Enumeration Date | 05/19/2014 |
| Last Update Date | 05/19/2014 |
| Medicare PECOS PAC ID | 1557586104 |
|---|---|
| Medicare Enrollment ID | O20140715002095 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922419365 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036131692 (Illinois) | Primary |
| Provider Name | Min Wang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386887701 PECOS PAC ID: 4880830546 Enrollment ID: I20130814000421 |
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