| Diagnostic Psychiatry Sc | |
|
4711 W Golf Rd Suite 400 Skokie IL 60076 | |
| (847) 679-3079 | |
| (847) 679-8340 |
| Full Name | Diagnostic Psychiatry Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4711 W Golf Rd, Skokie, Illinois |
| Authorized Official Name and Position | Antoinette Risdon (PRESIDENT) |
| Authorized Official Contact | 8476793079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic Psychiatry Sc 4711 W Golf Rd Suite 400 Skokie IL 60076 Ph: (847) 679-3079 | Diagnostic Psychiatry Sc 4711 W Golf Rd Suite 400 Skokie IL 60076 Ph: (847) 679-3079 |
| NPI Number | 1326159229 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7416025978 |
|---|---|
| Medicare Enrollment ID | O20081010000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326159229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Alain Erich Decastro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710080288 PECOS PAC ID: 4789752288 Enrollment ID: I20081010000474 |
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