| Clear Minds Better Lives Pc | |
|
1431 N Western Ave Ste 306 Chicago IL 60622-1775 | |
| (312) 445-0995 | |
| Not Available |
| Full Name | Clear Minds Better Lives Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1431 N Western Ave Ste 306, Chicago, Illinois |
| Authorized Official Name and Position | Annabella Vidal-ruiz (OWNER) |
| Authorized Official Contact | 3124450995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Minds Better Lives Pc Po Box 47304 Chicago IL 60647-0005 Ph: () - | Clear Minds Better Lives Pc 1431 N Western Ave Ste 306 Chicago IL 60622-1775 Ph: (312) 445-0995 |
| NPI Number | 1275056897 |
|---|---|
| Provider Enumeration Date | 07/25/2017 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Medicare PECOS PAC ID | 3577838242 |
|---|---|
| Medicare Enrollment ID | O20171005001206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275056897 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Annabella Vidal-ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063867760 PECOS PAC ID: 3375825623 Enrollment ID: I20170120001270 |
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