| Cognitive Behavioral Health Inc | |
|
350 S Northwest Hwy Suite 300 Park Ridge IL 60068-4216 | |
| (847) 877-5805 | |
| (773) 751-2250 |
| Full Name | Cognitive Behavioral Health Inc |
|---|---|
| Speciality | Psychologist |
| Location | 350 S Northwest Hwy, Park Ridge, Illinois |
| Authorized Official Name and Position | Shelley Daniels (PRESIDENT) |
| Authorized Official Contact | 8478775805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Behavioral Health Inc 350 S Northwest Hwy Suite 300 Park Ridge IL 60068-4216 Ph: (847) 877-5805 | Cognitive Behavioral Health Inc 350 S Northwest Hwy Suite 300 Park Ridge IL 60068-4216 Ph: (847) 877-5805 |
| NPI Number | 1649604828 |
|---|---|
| Provider Enumeration Date | 08/24/2013 |
| Last Update Date | 12/09/2013 |
| Medicare PECOS PAC ID | 8022245133 |
|---|---|
| Medicare Enrollment ID | O20131217001569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649604828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071007816 (Illinois) | Primary |
| Provider Name | Shelley Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568784841 PECOS PAC ID: 9537290945 Enrollment ID: I20100629000693 |
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