| Center For Emotional Peace S.c. | |
|
565 Lakeview Pkwy Suite 105 Vernon Hills IL 60061-1857 | |
| (847) 984-6585 | |
| Not Available |
| Full Name | Center For Emotional Peace S.c. |
|---|---|
| Speciality | Psychologist |
| Location | 565 Lakeview Pkwy, Vernon Hills, Illinois |
| Authorized Official Name and Position | Serge Sorokin (PRESIDENT) |
| Authorized Official Contact | 8477226118 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Emotional Peace S.c. 110 Green Bay Rd Apt. # 303 Glencoe IL 60022-2148 Ph: (847) 722-6118 | Center For Emotional Peace S.c. 565 Lakeview Pkwy Suite 105 Vernon Hills IL 60061-1857 Ph: (847) 984-6585 |
| NPI Number | 1215365564 |
|---|---|
| Provider Enumeration Date | 10/24/2013 |
| Last Update Date | 10/24/2013 |
| Medicare PECOS PAC ID | 2264667336 |
|---|---|
| Medicare Enrollment ID | O20131025000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215365564 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071008593 (Illinois) | Primary |
| Provider Name | Alex D Reynish |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689756579 PECOS PAC ID: 1658476312 Enrollment ID: I20070425000301 |
| Provider Name | Serge Sorokin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740540913 PECOS PAC ID: 5890920961 Enrollment ID: I20131029000001 |
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