| Chicago Area Behavioral Health Services Inc | |
|
5658 S Kolin Ave Unit 2 Chicago IL 60629-4839 | |
| (708) 876-7525 | |
| (708) 544-0630 |
| Full Name | Chicago Area Behavioral Health Services Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5658 S Kolin Ave Unit 2, Chicago, Illinois |
| Authorized Official Name and Position | Augustus Edeh (LCSW) |
| Authorized Official Contact | 7734127420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Area Behavioral Health Services Inc 150 W Saint Charles Rd Suite 123 Lombard IL 60148-2288 Ph: () - | Chicago Area Behavioral Health Services Inc 5658 S Kolin Ave Unit 2 Chicago IL 60629-4839 Ph: (708) 876-7525 |
| NPI Number | 1518318666 |
|---|---|
| Provider Enumeration Date | 06/29/2016 |
| Last Update Date | 08/11/2022 |
| Certification Date | 08/11/2022 |
| Medicare PECOS PAC ID | 4789977216 |
|---|---|
| Medicare Enrollment ID | O20160721001303 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518318666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149015078 (Illinois) | Primary |
| Provider Name | Augustus C Edeh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275807158 PECOS PAC ID: 7517129646 Enrollment ID: I20120507000197 |
| Provider Name | Iyare Imanlihen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114322823 PECOS PAC ID: 7012201130 Enrollment ID: I20160817001694 |
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