| Center For Psychological Services - Oak Lawn Ltd | |
|
10735 S Cicero Ave Suite 208 Oak Lawn IL 60453-5400 | |
| (708) 424-0001 | |
| (708) 424-1394 |
| Full Name | Center For Psychological Services - Oak Lawn Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 10735 S Cicero Ave, Oak Lawn, Illinois |
| Authorized Official Name and Position | Victoria Kowalsky Williams (OWNER AND HEAD OF THE PRACTICE) |
| Authorized Official Contact | 7084240001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Psychological Services - Oak Lawn Ltd 10735 S Cicero Ave Suite 208 Oak Lawn IL 60453-5400 Ph: (708) 424-0001 | Center For Psychological Services - Oak Lawn Ltd 10735 S Cicero Ave Suite 208 Oak Lawn IL 60453-5400 Ph: (708) 424-0001 |
| NPI Number | 1386604577 |
|---|---|
| Provider Enumeration Date | 03/23/2006 |
| Last Update Date | 04/17/2013 |
| Medicare PECOS PAC ID | 9234036211 |
|---|---|
| Medicare Enrollment ID | O20031217000764 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386604577 | NPI | - | NPPES |
| 01623005 | Other | IL | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 071 003598 (Illinois) | Primary |
Sudhir M Gokhale Md Sc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10735 S Cicero Ave Ste 100, Oak Lawn, IL 60453 Phone: 708-636-2211 Fax: 708-636-5552 | |
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