| Edge Counseling Solutions | |
|
1111 W Lake Cook Rd Buffalo Grove IL 60689 | |
| (847) 353-1500 | |
| (847) 465-1964 |
| Full Name | Edge Counseling Solutions |
|---|---|
| Speciality | Clinic/Center |
| Location | 1111 W Lake Cook Rd, Buffalo Grove, Illinois |
| Authorized Official Name and Position | Shanan Matthew Egger (CFO) |
| Authorized Official Contact | 8473531762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edge Counseling Solutions 1111 W Lake Cook Rd Buffalo Grove IL 60689 Ph: (847) 353-1500 | Edge Counseling Solutions 1111 W Lake Cook Rd Buffalo Grove IL 60689 Ph: (847) 353-1500 |
| NPI Number | 1124401179 |
|---|---|
| Provider Enumeration Date | 07/08/2015 |
| Last Update Date | 04/20/2021 |
| Certification Date | 04/20/2021 |
| Medicare PECOS PAC ID | 3678872702 |
|---|---|
| Medicare Enrollment ID | O20160425000917 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124401179 | NPI | - | NPPES |
| Provider Name | Annette Kathleen Lacey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780725572 PECOS PAC ID: 2466616487 Enrollment ID: I20120604000050 |
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