| Great Oaks Consulting Services | |
|
305 W Silver Spring Dr Glendale WI 53217 | |
| (414) 885-0080 | |
| (414) 885-0081 |
| Full Name | Great Oaks Consulting Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 305 W Silver Spring Dr, Glendale, Wisconsin |
| Authorized Official Name and Position | Ilva Elizabeth Vanvalkenburgh (OWNER AND PSYCHIATRIST) |
| Authorized Official Contact | 4148850080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Oaks Consulting Services 305 W Silver Spring Dr Glendale WI 53217 Ph: (414) 885-0080 | Great Oaks Consulting Services 305 W Silver Spring Dr Glendale WI 53217 Ph: (414) 885-0080 |
| NPI Number | 1669116810 |
|---|---|
| Provider Enumeration Date | 04/25/2022 |
| Last Update Date | 05/02/2022 |
| Certification Date | 05/02/2022 |
| Medicare PECOS PAC ID | 4082078944 |
|---|---|
| Medicare Enrollment ID | O20230911001892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669116810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ilva Elizabeth Van Valkenburgh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659453405 PECOS PAC ID: 4486545480 Enrollment ID: I20040322000064 |
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