| Chosen One Psychiatric Services | |
|
2141 E 90th St Chicago IL 60617-3052 | |
| (708) 833-9256 | |
| Not Available |
| Full Name | Chosen One Psychiatric Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2141 E 90th St, Chicago, Illinois |
| Authorized Official Name and Position | Mustapha Olugbemiga Olugbile (OWNER) |
| Authorized Official Contact | 7088339256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chosen One Psychiatric Services 2141 E 90th St Chicago IL 60617-3052 Ph: (708) 833-9256 | Chosen One Psychiatric Services 2141 E 90th St Chicago IL 60617-3052 Ph: (708) 833-9256 |
| NPI Number | 1568116358 |
|---|---|
| Provider Enumeration Date | 02/09/2022 |
| Last Update Date | 03/01/2022 |
| Certification Date | 03/01/2022 |
| Medicare PECOS PAC ID | 8022405695 |
|---|---|
| Medicare Enrollment ID | O20220429001736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568116358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Mustapha Olugbile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184197410 PECOS PAC ID: 3971841008 Enrollment ID: I20190214001073 |
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