| Center For Psychiatric Health | |
|
1600 W Walnut St Jacksonville IL 62650-1136 | |
| (217) 245-9541 | |
| (217) 243-2206 |
| Full Name | Center For Psychiatric Health |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1600 W Walnut St, Jacksonville, Illinois |
| Authorized Official Name and Position | Wendi D Graham (EXECUTIVE ASSISTANT) |
| Authorized Official Contact | 2174795663 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Psychiatric Health 1600 W Walnut St Jacksonville IL 62650-1136 Ph: (217) 245-9541 | Center For Psychiatric Health 1600 W Walnut St Jacksonville IL 62650-1136 Ph: (217) 245-9541 |
| NPI Number | 1063680239 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 03/22/2018 |
| Medicare PECOS PAC ID | 8729166228 |
|---|---|
| Medicare Enrollment ID | O20080424000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063680239 | NPI | - | NPPES |
| 6932018 | Other | IL | BCBS |
| Provider Name | Thomas Rebori |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649317835 PECOS PAC ID: 2668405143 Enrollment ID: I20050915000021 |
| Provider Name | Tracy A Stucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518022649 PECOS PAC ID: 8921194259 Enrollment ID: I20071018000374 |
| Provider Name | William G Loveland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417926619 PECOS PAC ID: 2466539168 Enrollment ID: I20080404000549 |
| Provider Name | Carrie Elizabeth Janus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831639194 PECOS PAC ID: 9133405491 Enrollment ID: I20170421000621 |
| Provider Name | Dawn Brown |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740481118 PECOS PAC ID: 0941473599 Enrollment ID: I20171122001544 |
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