| Elias Chediak, M.d., P.a. | |
|
601 Missouri St Ste 1 Lawrence KS 66044-2353 | |
| (785) 841-7430 | |
| (785) 841-6411 |
| Full Name | Elias Chediak, M.d., P.a. |
|---|---|
| Speciality | Counselor |
| Location | 601 Missouri St, Lawrence, Kansas |
| Authorized Official Name and Position | Elias Chediak (PSYCHIATRIST) |
| Authorized Official Contact | 7858417430 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elias Chediak, M.d., P.a. 601 Missouri St Ste 1 Lawrence KS 66044-2353 Ph: (785) 841-7430 | Elias Chediak, M.d., P.a. 601 Missouri St Ste 1 Lawrence KS 66044-2353 Ph: (785) 841-7430 |
| NPI Number | 1104942630 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7810943370 |
|---|---|
| Medicare Enrollment ID | O20050328000725 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104942630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elias Chediak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528060878 PECOS PAC ID: 5799731253 Enrollment ID: I20050328000752 |
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