| Ev Psychotherapy Pllc | |
|
935 Skidmore Dr Antioch IL 60002 | |
| (847) 313-1435 | |
| Not Available |
| Full Name | Ev Psychotherapy Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 935 Skidmore Dr, Antioch, Illinois |
| Authorized Official Name and Position | Elizabeth T Vogt (LCSW/OWNER) |
| Authorized Official Contact | 8473131435 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ev Psychotherapy Pllc 935 Skidmore Dr Antioch IL 60002-1547 Ph: (847) 313-1435 | Ev Psychotherapy Pllc 935 Skidmore Dr Antioch IL 60002 Ph: (847) 313-1435 |
| NPI Number | 1639835036 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 12/13/2022 |
| Certification Date | 12/13/2022 |
| Medicare PECOS PAC ID | 5092101030 |
|---|---|
| Medicare Enrollment ID | O20220331000865 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639835036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elizabeth T Vogt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134587744 PECOS PAC ID: 0143616185 Enrollment ID: I20220331001494 |
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