| Bridge2horizon Wellness Resource Llc | |
|
1020 Milwaukee Ave Ste 235 Deerfield IL 60015-3555 | |
| (847) 975-2331 | |
| Not Available |
| Full Name | Bridge2horizon Wellness Resource Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1020 Milwaukee Ave Ste 235, Deerfield, Illinois |
| Authorized Official Name and Position | Vladislav M Vayngart (OWNER/COO) |
| Authorized Official Contact | 8476300151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridge2horizon Wellness Resource Llc 1020 Milwaukee Ave Ste 235 Deerfield IL 60015-3555 Ph: (847) 630-0151 | Bridge2horizon Wellness Resource Llc 1020 Milwaukee Ave Ste 235 Deerfield IL 60015-3555 Ph: (847) 975-2331 |
| NPI Number | 1609342666 |
|---|---|
| Provider Enumeration Date | 10/17/2018 |
| Last Update Date | 11/20/2018 |
| Medicare PECOS PAC ID | 6103161112 |
|---|---|
| Medicare Enrollment ID | O20181219003082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609342666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nancy K Sillin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841740966 PECOS PAC ID: 5799066643 Enrollment ID: I20170109000274 |
| Provider Name | Yevgeny B Roginsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669895165 PECOS PAC ID: 2961746987 Enrollment ID: I20181203001527 |
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