| Carrie Spitalli, Psy.d., P.c. | |
|
110 Mooney Dr Ste 1 Bourbonnais IL 60914-2172 | |
| (815) 933-7887 | |
| Not Available |
| Full Name | Carrie Spitalli, Psy.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 110 Mooney Dr Ste 1, Bourbonnais, Illinois |
| Authorized Official Name and Position | Carrie Lynn Spitalli (PRESIDENT) |
| Authorized Official Contact | 8159337887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carrie Spitalli, Psy.d., P.c. 110 Mooney Dr Ste 1 Bourbonnais IL 60914-2172 Ph: (815) 933-7887 | Carrie Spitalli, Psy.d., P.c. 110 Mooney Dr Ste 1 Bourbonnais IL 60914-2172 Ph: (815) 933-7887 |
| NPI Number | 1093218737 |
|---|---|
| Provider Enumeration Date | 03/08/2018 |
| Last Update Date | 03/08/2018 |
| Medicare PECOS PAC ID | 8224399258 |
|---|---|
| Medicare Enrollment ID | O20180307001963 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093218737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071005739 (Illinois) | Primary |
| Provider Name | Carrie L Spitalli |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750354254 PECOS PAC ID: 4385907344 Enrollment ID: I20180404002952 |
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