| Associated Behavioral Consultants, Inc | |
|
4835 W Irving Park Rd Chicago IL 60641-2719 | |
| (773) 777-7413 | |
| Not Available |
| Full Name | Associated Behavioral Consultants, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 4835 W Irving Park Rd, Chicago, Illinois |
| Authorized Official Name and Position | Fred T Waltzer (PRESIDENT) |
| Authorized Official Contact | 7737777413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associated Behavioral Consultants, Inc 4835 W Irving Park Rd Chicago IL 60641-2719 Ph: (773) 777-7413 | Associated Behavioral Consultants, Inc 4835 W Irving Park Rd Chicago IL 60641-2719 Ph: (773) 777-7413 |
| NPI Number | 1760436398 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 10/20/2008 |
| Medicare PECOS PAC ID | 3971550880 |
|---|---|
| Medicare Enrollment ID | O20050404000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760436398 | NPI | - | NPPES |
| 36332274-60712-01 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | 149001505 (Illinois) | Primary |
| Provider Name | Fred T Waltzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306897087 PECOS PAC ID: 3971554874 Enrollment ID: I20060620000225 |
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