| Ethos Psychological Services Llc | |
|
444 N Northwest Hwy Ste 375 Park Ridge IL 60068-3271 | |
| (917) 403-4631 | |
| Not Available |
| Full Name | Ethos Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 444 N Northwest Hwy Ste 375, Park Ridge, Illinois |
| Authorized Official Name and Position | John Eliot Leffel (DIRECTOR) |
| Authorized Official Contact | 9174034631 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ethos Psychological Services Llc 7903 Lowell Ave Skokie IL 60076-3537 Ph: (917) 403-4631 | Ethos Psychological Services Llc 444 N Northwest Hwy Ste 375 Park Ridge IL 60068-3271 Ph: (917) 403-4631 |
| NPI Number | 1316466857 |
|---|---|
| Provider Enumeration Date | 09/15/2017 |
| Last Update Date | 05/03/2022 |
| Certification Date | 05/03/2022 |
| Medicare PECOS PAC ID | 4183990005 |
|---|---|
| Medicare Enrollment ID | O20171020001882 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316466857 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071008161 (Illinois) | Primary |
| Provider Name | John E Leffel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205146958 PECOS PAC ID: 9133390156 Enrollment ID: I20110923000451 |
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