| Group For Psychological Services Ltd | |
|
405 N Wabash Ave Suite 606 Chicago IL 60611-3591 | |
| (312) 222-9797 | |
| Not Available |
| Full Name | Group For Psychological Services Ltd |
|---|---|
| Speciality | Psychologist |
| Location | 405 N Wabash Ave, Chicago, Illinois |
| Authorized Official Name and Position | Ralph Levinson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3122229797 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Group For Psychological Services Ltd 2306 Ridge Ave Evanston IL 60201-2617 Ph: (847) 328-2573 | Group For Psychological Services Ltd 405 N Wabash Ave Suite 606 Chicago IL 60611-3591 Ph: (312) 222-9797 |
| NPI Number | 1194804526 |
|---|---|
| Provider Enumeration Date | 11/05/2006 |
| Last Update Date | 01/31/2012 |
| Medicare PECOS PAC ID | 1759545312 |
|---|---|
| Medicare Enrollment ID | O20120611000464 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194804526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071-3208 (Illinois) | Primary |
| Provider Name | Dianne Burgin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497764666 PECOS PAC ID: 6305000977 Enrollment ID: I20120611000600 |
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