| Glenview Office | |
|
3633 W Lake Ave Suite 305 Glenview IL 60026-5805 | |
| (847) 657-7337 | |
| (847) 657-7331 |
| Full Name | Glenview Office |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3633 W Lake Ave, Glenview, Illinois |
| Authorized Official Name and Position | Kate Mahoney (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8474921778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenview Office 3633 W Lake Ave Suite 305 Glenview IL 60026-5805 Ph: (847) 657-7337 | Glenview Office 3633 W Lake Ave Suite 305 Glenview IL 60026-5805 Ph: (847) 657-7337 |
| NPI Number | 1720225725 |
|---|---|
| Provider Enumeration Date | 01/13/2009 |
| Last Update Date | 01/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720225725 | NPI | - | NPPES |
| A-0502-0002-A | Other | IL | STATE OF ILLINOIS DHS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-0502-0002-A (Illinois) | Primary |
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