| Dwb Human Services Inc | |
|
4350 N Hermitage Ave Chicago IL 60613-1106 | |
| (773) 327-9356 | |
| (773) 348-8220 |
| Full Name | Dwb Human Services Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4350 N Hermitage Ave, Chicago, Illinois |
| Authorized Official Name and Position | Dianna Bolen (OWNER) |
| Authorized Official Contact | 7733279356 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dwb Human Services Inc 4350 N Hermitage Ave Chicago IL 60613-1106 Ph: (773) 327-9356 | Dwb Human Services Inc 4350 N Hermitage Ave Chicago IL 60613-1106 Ph: (773) 327-9356 |
| NPI Number | 1891827655 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 06/29/2009 |
| Medicare PECOS PAC ID | 8729139894 |
|---|---|
| Medicare Enrollment ID | O20090701000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891827655 | NPI | - | NPPES |
| 01632869 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 071-006419 (Illinois) | Primary |
| Provider Name | Dianna W Bolen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417089293 PECOS PAC ID: 5193876266 Enrollment ID: I20090701000040 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |