| Bmsc Az Llc | |
|
10204 Bode St Ste B Plainfield IL 60585-9813 | |
| (855) 241-7160 | |
| (954) 324-8354 |
| Full Name | Bmsc Az Llc |
|---|---|
| Speciality | Social Worker |
| Location | 10204 Bode St Ste B, Plainfield, Illinois |
| Authorized Official Name and Position | Melanie Donohue (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8552417160 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bmsc Az Llc 10204 Bode St Ste B Plainfield IL 60585-9813 Ph: (855) 241-7160 | Bmsc Az Llc 10204 Bode St Ste B Plainfield IL 60585-9813 Ph: (855) 241-7160 |
| NPI Number | 1497201875 |
|---|---|
| Provider Enumeration Date | 08/26/2016 |
| Last Update Date | 05/18/2021 |
| Certification Date | 05/18/2021 |
| Medicare PECOS PAC ID | 4385929173 |
|---|---|
| Medicare Enrollment ID | O20170317000545 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497201875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth A Weise |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952723652 PECOS PAC ID: 2668451386 Enrollment ID: I20140414001095 |
| Provider Name | Troy J Loosle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316366057 PECOS PAC ID: 3173741857 Enrollment ID: I20140820002894 |
| Provider Name | Melissa A Drinkman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932512456 PECOS PAC ID: 8022304443 Enrollment ID: I20160912001891 |
| Provider Name | Denise A Rae |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912449083 PECOS PAC ID: 0749569234 Enrollment ID: I20161128002708 |
| Provider Name | Suzanne K Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861608861 PECOS PAC ID: 0941582027 Enrollment ID: I20170125001349 |
| Provider Name | Ligen Feller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649607078 PECOS PAC ID: 5890123822 Enrollment ID: I20200325000892 |
| Provider Name | Olivia Mora-lett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194114926 PECOS PAC ID: 9931425345 Enrollment ID: I20210105003088 |
| Provider Name | Shahrezad Chiha |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194260083 PECOS PAC ID: 7517366776 Enrollment ID: I20210520002408 |
| Provider Name | Donna Laluya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134260144 PECOS PAC ID: 6800951567 Enrollment ID: I20210715004018 |
| Provider Name | Renee Tong |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811494347 PECOS PAC ID: 7911259759 Enrollment ID: I20220517002887 |
| Provider Name | Maria Schick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952522385 PECOS PAC ID: 5991774358 Enrollment ID: I20220718001895 |
| Provider Name | Maili Batista |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235466491 PECOS PAC ID: 3072989334 Enrollment ID: I20221012001688 |
| Provider Name | Sarah Rice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700010634 PECOS PAC ID: 0143686311 Enrollment ID: I20230512000743 |
| Provider Name | Valerie Turpin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326827627 PECOS PAC ID: 3870939374 Enrollment ID: I20240306003748 |
| Provider Name | Alicia Fahr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1720242399 PECOS PAC ID: 2264804020 Enrollment ID: I20240425003762 |
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