| Emotion Management Program | |
|
1800 Ravinia Pl Orland Park IL 60462-3761 | |
| (708) 403-7570 | |
| (708) 403-7546 |
| Full Name | Emotion Management Program |
|---|---|
| Speciality | Psychologist |
| Location | 1800 Ravinia Pl, Orland Park, Illinois |
| Authorized Official Name and Position | Eugene Paul Holmes (MANAGING PARTNER) |
| Authorized Official Contact | 7084037580 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emotion Management Program Po Box 747 Blue Island IL 60406-0747 Ph: (708) 403-7570 | Emotion Management Program 1800 Ravinia Pl Orland Park IL 60462-3761 Ph: (708) 403-7570 |
| NPI Number | 1083780522 |
|---|---|
| Provider Enumeration Date | 11/27/2006 |
| Last Update Date | 07/30/2010 |
| Medicare PECOS PAC ID | 8628171360 |
|---|---|
| Medicare Enrollment ID | O20070316000336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083780522 | NPI | - | NPPES |
| 279826 | Other | IL | MAGELLAN |
| 01634764 | Other | IL | BCBSIL PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180000522 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | 071005108 (Illinois) | Primary |
| Provider Name | Eugene Paul Holmes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790861664 PECOS PAC ID: 2860453586 Enrollment ID: I20041025001102 |
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