| Beshers Psychotherapy Services, Ltd | |
|
636 Church St Ste 415 Evanston IL 60201-4580 | |
| (217) 390-4754 | |
| Not Available |
| Full Name | Beshers Psychotherapy Services, Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 636 Church St Ste 415, Evanston, Illinois |
| Authorized Official Name and Position | Maxwell N Beshers (OWNER) |
| Authorized Official Contact | 2173904754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beshers Psychotherapy Services, Ltd 2225 W Chicago Ave Apt B Chicago IL 60622-6884 Ph: (217) 390-4754 | Beshers Psychotherapy Services, Ltd 636 Church St Ste 415 Evanston IL 60201-4580 Ph: (217) 390-4754 |
| NPI Number | 1326508763 |
|---|---|
| Provider Enumeration Date | 03/21/2019 |
| Last Update Date | 03/21/2019 |
| Medicare PECOS PAC ID | 0042642191 |
|---|---|
| Medicare Enrollment ID | O20191112001539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326508763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Maxwell Beshers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447619028 PECOS PAC ID: 6305127341 Enrollment ID: I20170105000389 |
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