| Arcc Neuropsychology | |
|
477 E Butterfield Rd Ste 102 Lombard IL 60148-4880 | |
| (630) 424-8900 | |
| (630) 424-9017 |
| Full Name | Arcc Neuropsychology |
|---|---|
| Speciality | Clinic/Center |
| Location | 477 E Butterfield Rd Ste 102, Lombard, Illinois |
| Authorized Official Name and Position | Randall Warren Summerville (OWNER) |
| Authorized Official Contact | 6304248900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arcc Neuropsychology 477 E Butterfield Rd Ste 102 Lombard IL 60148-4880 Ph: (630) 424-8900 | Arcc Neuropsychology 477 E Butterfield Rd Ste 102 Lombard IL 60148-4880 Ph: (630) 424-8900 |
| NPI Number | 1932264207 |
|---|---|
| Provider Enumeration Date | 12/26/2006 |
| Last Update Date | 12/05/2022 |
| Certification Date | 12/05/2022 |
| Medicare PECOS PAC ID | 5799881488 |
|---|---|
| Medicare Enrollment ID | O20070425000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932264207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Secondary |
| 261QM0850X | Clinic/center - Adult Mental Health | 071002647 (Illinois) | Primary |
| Provider Name | Randall Warren Summerville |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821180803 PECOS PAC ID: 0244275881 Enrollment ID: I20050623000418 |
| Provider Name | Kristen Anne Wright |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336454891 PECOS PAC ID: 9335491380 Enrollment ID: I20181003000397 |
| Provider Name | Kristin Elizabeth Machuta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205598943 PECOS PAC ID: 1153719596 Enrollment ID: I20211103003295 |
| Provider Name | Chelsea A Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700543519 PECOS PAC ID: 4183014996 Enrollment ID: I20211210001058 |
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