Bespoke Psychiatry | |
1203 W Augusta Blvd Ste 1 Chicago IL 60642-4327 | |
(773) 248-2255 | |
Not Available |
Full Name | Bespoke Psychiatry |
---|---|
Speciality | Psychiatry & Neurology |
Location | 1203 W Augusta Blvd Ste 1, Chicago, Illinois |
Authorized Official Name and Position | Martha C Hnatiw (ACCOUNT MANAGER) |
Authorized Official Contact | 6302411495 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bespoke Psychiatry 1203 W Augusta Blvd Ste 1 Chicago IL 60642-4327 Ph: (773) 248-2255 | Bespoke Psychiatry 1203 W Augusta Blvd Ste 1 Chicago IL 60642-4327 Ph: (773) 248-2255 |
NPI Number | 1952937104 |
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Provider Enumeration Date | 03/19/2020 |
Last Update Date | 02/02/2022 |
Certification Date | 02/02/2022 |
Medicare PECOS PAC ID | 3274951744 |
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Medicare Enrollment ID | O20200915002352 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952937104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Pamela S Brodt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982737789 PECOS PAC ID: 3577658590 Enrollment ID: I20071004000696 |
Provider Name | Patricia R Pipp |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679738348 PECOS PAC ID: 7517025604 Enrollment ID: I20081017000508 |
Provider Name | Ekalak Yodchai |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609395383 PECOS PAC ID: 4688930944 Enrollment ID: I20171102002146 |
Provider Name | Krushen Pillay |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1568812253 PECOS PAC ID: 7911299870 Enrollment ID: I20181002003264 |
Provider Name | Jacob Fyda |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1992168322 PECOS PAC ID: 0941597801 Enrollment ID: I20181107001790 |
Provider Name | Christina N High |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730664053 PECOS PAC ID: 9638413156 Enrollment ID: I20181210001831 |
Provider Name | Katrina K Berres |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831665231 PECOS PAC ID: 6305181918 Enrollment ID: I20181228001610 |
Provider Name | Theresa K Scheerenberger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457823544 PECOS PAC ID: 3577802230 Enrollment ID: I20190225002855 |
Provider Name | Olivia C Castellanos |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821551599 PECOS PAC ID: 5597007781 Enrollment ID: I20190509000847 |
Provider Name | Bashiru Babawale |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982163085 PECOS PAC ID: 5890028534 Enrollment ID: I20190912001690 |
Provider Name | Jackie R Rajani |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1073043352 PECOS PAC ID: 2163751363 Enrollment ID: I20190913001294 |
Provider Name | Hao Cheng |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1932630993 PECOS PAC ID: 0941571772 Enrollment ID: I20191112001797 |
Provider Name | Jennifer Harkey |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1790214674 PECOS PAC ID: 1850723834 Enrollment ID: I20191113000014 |
Provider Name | Bimbola M Amoranbini |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1770145278 PECOS PAC ID: 8123450863 Enrollment ID: I20191118001914 |
Provider Name | Elizabette Nava |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861970642 PECOS PAC ID: 5597197145 Enrollment ID: I20191120000189 |
Provider Name | Ernest Ogbeide |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235763863 PECOS PAC ID: 1456776830 Enrollment ID: I20200731002148 |
Provider Name | Tracy M Jacobson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1114529781 PECOS PAC ID: 5294146635 Enrollment ID: I20201116002318 |
Provider Name | Jennifer Lynn Adams |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1487185260 PECOS PAC ID: 7315370012 Enrollment ID: I20201205000017 |
Provider Name | Benjamin S Shin |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1740654078 PECOS PAC ID: 9638581929 Enrollment ID: I20201210000527 |
Provider Name | Ladan Khazai |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518318716 PECOS PAC ID: 1951696301 Enrollment ID: I20201210001657 |
Provider Name | Osasumwen O Igbinoba |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942833306 PECOS PAC ID: 9032536438 Enrollment ID: I20201212000014 |
Provider Name | Alan Akira |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1710470257 PECOS PAC ID: 3476809187 Enrollment ID: I20210302001649 |
Provider Name | Tawakalitu Afolashade Babawale |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043820517 PECOS PAC ID: 1557770427 Enrollment ID: I20210505000830 |
Provider Name | Chanelle Christine Bates |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457986929 PECOS PAC ID: 3971902594 Enrollment ID: I20210601001428 |
Provider Name | Jamila Oladipo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1679108153 PECOS PAC ID: 3779804471 Enrollment ID: I20210828000336 |
Provider Name | Susan Gierczyk |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124697719 PECOS PAC ID: 4981092293 Enrollment ID: I20211019001115 |
Provider Name | Elaina May Barraza |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558937508 PECOS PAC ID: 6507254869 Enrollment ID: I20211019003157 |
Provider Name | Sonya Mohan |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1922452408 PECOS PAC ID: 2860804267 Enrollment ID: I20211105000554 |
Provider Name | Daleena J Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184212128 PECOS PAC ID: 7214326347 Enrollment ID: I20211111001147 |
Provider Name | Aishah Asma Yanssaneh |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417485525 PECOS PAC ID: 4385912682 Enrollment ID: I20211118001093 |
Provider Name | Cristina Rojas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1619617891 PECOS PAC ID: 6608262969 Enrollment ID: I20220413002191 |
Provider Name | Anh Nguyen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508437484 PECOS PAC ID: 0648667162 Enrollment ID: I20220429001985 |
Provider Name | Amanda Dawn Thoennes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629275953 PECOS PAC ID: 2062898802 Enrollment ID: I20221003001714 |
Provider Name | Ahmed Maki |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1215466164 PECOS PAC ID: 5698147106 Enrollment ID: I20230209002849 |
Provider Name | Sol Estrada |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457055451 PECOS PAC ID: 3173988789 Enrollment ID: I20230504001769 |
Provider Name | Rhiannon L Richards |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063120897 PECOS PAC ID: 5395101901 Enrollment ID: I20230523002432 |
Provider Name | Ethan Jose Eder Sanchez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1922703487 PECOS PAC ID: 1557728763 Enrollment ID: I20230602001776 |
Provider Name | Angelique Bautista Gabat |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003514985 PECOS PAC ID: 2769849728 Enrollment ID: I20230606002999 |
Provider Name | Cawonda Ranee Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1417648148 PECOS PAC ID: 3274994512 Enrollment ID: I20230802001846 |
Provider Name | Shawna Donaldson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902595226 PECOS PAC ID: 3274996202 Enrollment ID: I20230824000181 |
Provider Name | Kelsey Jordan Frain |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649057795 PECOS PAC ID: 0547616849 Enrollment ID: I20231023002372 |
Provider Name | Jamie Fyda |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1518548429 PECOS PAC ID: 6507265949 Enrollment ID: I20231107000069 |
Provider Name | Shaniqua Jackson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1801562517 PECOS PAC ID: 7214384650 Enrollment ID: I20231107002632 |
Provider Name | Mary Ann Longalong Villalon |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447936984 PECOS PAC ID: 1850748211 Enrollment ID: I20231107003731 |
Provider Name | Terri D Gray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629840046 PECOS PAC ID: 7618324435 Enrollment ID: I20231115002075 |
Provider Name | Eric Yi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154007748 PECOS PAC ID: 6002265048 Enrollment ID: I20231215000711 |
Provider Name | Glenn Agape Edillor Montero |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1124805189 PECOS PAC ID: 2264881168 Enrollment ID: I20231216000204 |
Provider Name | Mary Jane G Evangelista |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720760010 PECOS PAC ID: 2163871062 Enrollment ID: I20231216000242 |
Provider Name | Caroline Bernardi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912525544 PECOS PAC ID: 8628412640 Enrollment ID: I20240219000825 |
Provider Name | Loretta Chidinma Armstrong |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003591017 PECOS PAC ID: 7810331774 Enrollment ID: I20240219002390 |
Provider Name | Eric William Leppink |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1972185940 PECOS PAC ID: 9830590801 Enrollment ID: I20240405001378 |
Provider Name | Nakib Mansuri |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1093380818 PECOS PAC ID: 1850794801 Enrollment ID: I20240520000954 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |