| Chicago Psychological Health Center, Llc | |
|
2518 N Lincoln Ave Chicago IL 60614-2782 | |
| (773) 469-6675 | |
| Not Available |
| Full Name | Chicago Psychological Health Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2518 N Lincoln Ave, Chicago, Illinois |
| Authorized Official Name and Position | Thomas Alcock (THERAPIST) |
| Authorized Official Contact | 7734696675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Psychological Health Center, Llc 2518 N Lincoln Ave Chicago IL 60614-2782 Ph: () - | Chicago Psychological Health Center, Llc 2518 N Lincoln Ave Chicago IL 60614-2782 Ph: (773) 469-6675 |
| NPI Number | 1912332776 |
|---|---|
| Provider Enumeration Date | 09/11/2013 |
| Last Update Date | 09/11/2013 |
| Medicare PECOS PAC ID | 4880912096 |
|---|---|
| Medicare Enrollment ID | O20150420002225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912332776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 180008478 (Illinois) | Primary |
| Provider Name | Tom Alcock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790051514 PECOS PAC ID: 5395973614 Enrollment ID: I20150422000287 |
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