| Catalyst Clinical Group, Inc | |
|
4305 N Lincoln Ave Suite M Chicago IL 60618-1711 | |
| (312) 834-5487 | |
| Not Available |
| Full Name | Catalyst Clinical Group, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 4305 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Lucas Byron Swenink (OWNER) |
| Authorized Official Contact | 7738768763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Catalyst Clinical Group, Inc 4305 N Lincoln Ave Suite M Chicago IL 60618-1711 Ph: (312) 834-5487 | Catalyst Clinical Group, Inc 4305 N Lincoln Ave Suite M Chicago IL 60618-1711 Ph: (312) 834-5487 |
| NPI Number | 1316397979 |
|---|---|
| Provider Enumeration Date | 06/14/2016 |
| Last Update Date | 11/07/2018 |
| Medicare PECOS PAC ID | 5799029849 |
|---|---|
| Medicare Enrollment ID | O20181130001556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316397979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 150.015780 (Illinois) | Secondary |
| 1041C0700X | Social Worker - Clinical | 149.015898 (Illinois) | Primary |
| Provider Name | Lucas B Swenink |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609212802 PECOS PAC ID: 2668612029 Enrollment ID: I20130708000318 |
| Provider Name | Jeffrey Robert Pyritz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073064895 PECOS PAC ID: 1052736774 Enrollment ID: I20200729000226 |
| Provider Name | Lauren Grace Mosley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477025385 PECOS PAC ID: 2466874136 Enrollment ID: I20210722000080 |
| Provider Name | Jessica G Gwilliam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922679976 PECOS PAC ID: 2961805163 Enrollment ID: I20210726002965 |
| Provider Name | Mengqi Zhu |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457949216 PECOS PAC ID: 4082088679 Enrollment ID: I20230322001354 |
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