| Camelot Care Centers, Llc | |
|
333 W Pierce Rd Suite 175 Itasca IL 60143-3116 | |
| (630) 773-1985 | |
| (630) 773-1988 |
| Full Name | Camelot Care Centers, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 333 W Pierce Rd, Itasca, Illinois |
| Authorized Official Name and Position | Ronica R Patel (STATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6307731985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Care Centers, Llc 333 W Pierce Rd Suite 175 Itasca IL 60143-3116 Ph: (630) 773-1985 | Camelot Care Centers, Llc 333 W Pierce Rd Suite 175 Itasca IL 60143-3116 Ph: (630) 773-1985 |
| NPI Number | 1093957300 |
|---|---|
| Provider Enumeration Date | 04/01/2009 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093957300 | NPI | - | NPPES |
| 2B05-IPI-141 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Camelot Care Centers, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 333 W Pierce Rd Ste 175, Itasca, IL 60143 Phone: 630-773-1985 | |
Chicago Autism And Behavior Specialists Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 W Hawthorn Drive, Itasca, IL 60143 Phone: 800-844-1232 Fax: 800-844-1232 | |
Chicago Autism & Behavior Specialists Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 901 W Hawthorn Dr, Itasca, IL 60143 Phone: 800-844-1232 Fax: 800-844-1232 |