| Center Services Inc | |
|
3624 W 216th Street Matteson IL 60443-2713 | |
| (708) 481-4080 | |
| (708) 481-7725 |
| Full Name | Center Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3624 W 216th Street, Matteson, Illinois |
| Authorized Official Name and Position | Timothy W Pedigo (SECRETARY TREASURER) |
| Authorized Official Contact | 7084814080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center Services Inc 3624 W 216th Street Matteson IL 60443-2713 Ph: (708) 481-4080 | Center Services Inc 3624 W 216th Street Matteson IL 60443-2713 Ph: (708) 481-4080 |
| NPI Number | 1902982127 |
|---|---|
| Provider Enumeration Date | 10/31/2006 |
| Last Update Date | 06/07/2008 |
| Medicare PECOS PAC ID | 1153412937 |
|---|---|
| Medicare Enrollment ID | O20110210000396 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902982127 | NPI | - | NPPES |
| 01636410 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Timothy W Pedigo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861586760 PECOS PAC ID: 4082894811 Enrollment ID: I20110223000112 |
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