| Gray Health Inc | |
|
5214 N Western Ave Ste 303 Chicago IL 60625-2592 | |
| (773) 373-9175 | |
| (320) 205-1753 |
| Full Name | Gray Health Inc |
|---|---|
| Speciality | Social Worker |
| Location | 5214 N Western Ave Ste 303, Chicago, Illinois |
| Authorized Official Name and Position | Trover Gray Wilson (OWNER/OPERATOR) |
| Authorized Official Contact | 7733739175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gray Health Inc 6033 N Sheridan Rd Apt 19ab Chicago IL 60660-3003 Ph: (773) 373-9175 | Gray Health Inc 5214 N Western Ave Ste 303 Chicago IL 60625-2592 Ph: (773) 373-9175 |
| NPI Number | 1053760108 |
|---|---|
| Provider Enumeration Date | 06/09/2016 |
| Last Update Date | 05/15/2021 |
| Certification Date | 05/15/2021 |
| Medicare PECOS PAC ID | 3870887508 |
|---|---|
| Medicare Enrollment ID | O20160803001926 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053760108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149015915 (Illinois) | Primary |
| Provider Name | Trover Gray Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427358993 PECOS PAC ID: 6901032572 Enrollment ID: I20131204001392 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
Young Adult Program Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |