| Decatur Psychiatry Ltd | |
|
2580 E Federal Dr Ste 403 Decatur IL 62526-2189 | |
| (217) 809-0429 | |
| (217) 422-0041 |
| Full Name | Decatur Psychiatry Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2580 E Federal Dr Ste 403, Decatur, Illinois |
| Authorized Official Name and Position | Anjum Bashir (OWNER) |
| Authorized Official Contact | 2178090429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Decatur Psychiatry Ltd 2580 E Federal Dr Ste 403 Decatur IL 62526-2189 Ph: (217) 809-0429 | Decatur Psychiatry Ltd 2580 E Federal Dr Ste 403 Decatur IL 62526-2189 Ph: (217) 809-0429 |
| NPI Number | 1770638686 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 10/04/2024 |
| Certification Date | 10/04/2024 |
| Medicare PECOS PAC ID | 8426065186 |
|---|---|
| Medicare Enrollment ID | O20060321000610 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770638686 | NPI | - | NPPES |
| 036105848 | Medicaid | IL | |
| 213272 | Other | IL | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036105848 (Illinois) | Primary |
| Provider Name | Anjum Bashir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568440683 PECOS PAC ID: 3678580347 Enrollment ID: I20060322000022 |
| Provider Name | Beverly J Matthews |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558463760 PECOS PAC ID: 6608814025 Enrollment ID: I20070301000374 |
| Provider Name | Annie Michele Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902340730 PECOS PAC ID: 3173885506 Enrollment ID: I20180326000263 |
| Provider Name | Amanda Stout |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942053616 PECOS PAC ID: 5092251025 Enrollment ID: I20240725002520 |
A & E Behavioral Health Care Associates Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2570 Federal Drive, Decatur, IL 62526 Phone: 217-872-1003 Fax: 217-233-4150 | |
Armor Bearer Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 861 W William St, Decatur, IL 62522 Phone: 217-402-4226 | |
Decatur Psychological Associates Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 3040 N University Ave, Suite 2, Decatur, IL 62526 Phone: 217-872-1700 Fax: 217-872-1366 |