| Beth Ledvora M.d. S.c. | |
|
7350 W College Dr Ste 106 Palos Heights IL 60463-1188 | |
| (708) 361-5110 | |
| (708) 361-5305 |
| Full Name | Beth Ledvora M.d. S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7350 W College Dr Ste 106, Palos Heights, Illinois |
| Authorized Official Name and Position | Beth Ledvora (PRESIDENT) |
| Authorized Official Contact | 7083615110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beth Ledvora M.d. S.c. 7350 W College Dr Ste 106 Palos Heights IL 60463-1188 Ph: (708) 361-5110 | Beth Ledvora M.d. S.c. 7350 W College Dr Ste 106 Palos Heights IL 60463-1188 Ph: (708) 361-5110 |
| NPI Number | 1003256462 |
|---|---|
| Provider Enumeration Date | 07/01/2013 |
| Last Update Date | 07/01/2013 |
| Medicare PECOS PAC ID | 4587898754 |
|---|---|
| Medicare Enrollment ID | O20131002000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003256462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036073475 (Illinois) | Primary |
| Provider Name | James S Riedel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871639203 PECOS PAC ID: 4587629217 Enrollment ID: I20041122001155 |
| Provider Name | Zenaida L Vivar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487780516 PECOS PAC ID: 0840257366 Enrollment ID: I20041216000519 |
| Provider Name | Rian Jonathan Rowles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447398870 PECOS PAC ID: 5799728945 Enrollment ID: I20050608000454 |
| Provider Name | Jesse L Munoz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649390675 PECOS PAC ID: 4082643713 Enrollment ID: I20050811000995 |
| Provider Name | Beth Ledvora |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104993161 PECOS PAC ID: 4789749466 Enrollment ID: I20090212000223 |
| Provider Name | David Eric Kemp |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710061486 PECOS PAC ID: 9234137407 Enrollment ID: I20141030001382 |
| Provider Name | Ryan A Rosenberger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295140945 PECOS PAC ID: 0244538684 Enrollment ID: I20180719003999 |
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