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240 S 5th Ave Suite B St Charles IL 60174-2905 | |
| (314) 223-2993 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 240 S 5th Ave, St Charles, Illinois |
| Authorized Official Name and Position | Eric Ward Nolan (CHILD AND ADOLESCENT PSYCHIATRIST) |
| Authorized Official Contact | 3142232993 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
40w615 Stonebriar Ln Elgin IL 60124-8162 Ph: (314) 223-2993 | 240 S 5th Ave Suite B St Charles IL 60174-2905 Ph: (314) 223-2993 |
| NPI Number | 1467712414 |
|---|---|
| Provider Enumeration Date | 05/24/2012 |
| Last Update Date | 05/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467712414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 036-121-588 (Illinois) | Primary |
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