| Comprehensive Clinical Services Pc | |
|
2340 S Highland Ave Suite 300 Lombard IL 60148-5371 | |
| (630) 261-1210 | |
| (630) 261-1211 |
| Full Name | Comprehensive Clinical Services Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2340 S Highland Ave, Lombard, Illinois |
| Authorized Official Name and Position | Maribel Favela (OFFICE MANAGER) |
| Authorized Official Contact | 6302611210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Comprehensive Clinical Services Pc 2340 S Highland Ave Suite 300 Lombard IL 60148-5371 Ph: (630) 261-1210 | Comprehensive Clinical Services Pc 2340 S Highland Ave Suite 300 Lombard IL 60148-5371 Ph: (630) 261-1210 |
| NPI Number | 1942484522 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 03/05/2024 |
| Certification Date | 03/05/2024 |
| Medicare PECOS PAC ID | 0042374720 |
|---|---|
| Medicare Enrollment ID | O20090123000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942484522 | NPI | - | NPPES |
| Provider Name | Samina N Khattak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801888037 PECOS PAC ID: 4082607270 Enrollment ID: I20040405000836 |
| Provider Name | Daniel B Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194896878 PECOS PAC ID: 4385633668 Enrollment ID: I20040511000975 |
| Provider Name | Aamir Safdar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245336205 PECOS PAC ID: 5193775047 Enrollment ID: I20050127000820 |
| Provider Name | Sheila C Rao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831112374 PECOS PAC ID: 3375597404 Enrollment ID: I20050329000080 |
| Provider Name | Rachel P Mikula |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306058508 PECOS PAC ID: 0840385662 Enrollment ID: I20071009000081 |
| Provider Name | Eloisa Rosales |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326222647 PECOS PAC ID: 9335206739 Enrollment ID: I20090331000061 |
| Provider Name | Joseph W Mullen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972778801 PECOS PAC ID: 0941288989 Enrollment ID: I20100730000396 |
| Provider Name | Dennis Keppeler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235326968 PECOS PAC ID: 1658513783 Enrollment ID: I20130820000149 |
| Provider Name | Blair M Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215377510 PECOS PAC ID: 7719112549 Enrollment ID: I20131031001645 |
| Provider Name | Marian R Glenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265858013 PECOS PAC ID: 9830314715 Enrollment ID: I20140709001052 |
| Provider Name | Erin M Petrusic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124432497 PECOS PAC ID: 8325366867 Enrollment ID: I20150414001434 |
| Provider Name | Davena Janeen Beal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407391212 PECOS PAC ID: 7810273919 Enrollment ID: I20170403002215 |
| Provider Name | Edward D Buck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750755625 PECOS PAC ID: 6204195332 Enrollment ID: I20180118002106 |
| Provider Name | Ralph M Romero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508182486 PECOS PAC ID: 9638425838 Enrollment ID: I20180630000113 |
| Provider Name | Paul Joseph Flaherty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659913036 PECOS PAC ID: 1850706151 Enrollment ID: I20210218002574 |
| Provider Name | Stephanie Lilly |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588974711 PECOS PAC ID: 9436466976 Enrollment ID: I20240126002364 |
| Provider Name | Biatriz Rivera Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548881543 PECOS PAC ID: 8628419652 Enrollment ID: I20240508002630 |
| Provider Name | Cagney Damien Cappelli |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447392501 PECOS PAC ID: 2567900798 Enrollment ID: I20240819002251 |
| Provider Name | Maria R Valdez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689882946 PECOS PAC ID: 3072053990 Enrollment ID: I20240906000748 |
| Provider Name | Mercedes Moreira Mayo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659003069 PECOS PAC ID: 3274074471 Enrollment ID: I20240916000303 |
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