| Associates In Behavioral Health S C | |
|
410 Hickory St Waukegan IL 60085-3936 | |
| (847) 817-1280 | |
| (847) 336-1601 |
| Full Name | Associates In Behavioral Health S C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 410 Hickory St, Waukegan, Illinois |
| Authorized Official Name and Position | Janine Mary Goldstein (CEO) |
| Authorized Official Contact | 8478171280 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associates In Behavioral Health S C 410 Hickory St Waukegan IL 60085-3936 Ph: (847) 817-1280 | Associates In Behavioral Health S C 410 Hickory St Waukegan IL 60085-3936 Ph: (847) 817-1280 |
| NPI Number | 1679786495 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4981763646 |
|---|---|
| Medicare Enrollment ID | O20081110000590 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679786495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Illinois) | Primary |
| Provider Name | Ismael C Lee Chuy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487798971 PECOS PAC ID: 3274692934 Enrollment ID: I20081110000570 |
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