| Iconpsychologies | |
|
8961 Enclave Dr Burr Ridge IL 60527-8394 | |
| (312) 342-6066 | |
| Not Available |
| Full Name | Iconpsychologies |
|---|---|
| Speciality | Counselor - Professional |
| Location | 8961 Enclave Dr, Burr Ridge, Illinois |
| Authorized Official Name and Position | Soberekon Melvin Koko (PRESIDENT/CEO) |
| Authorized Official Contact | 7739339300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Iconpsychologies 1750 E 87th St Suit 109 Chicago IL 60617-2713 Ph: (773) 933-9300 | Iconpsychologies 8961 Enclave Dr Burr Ridge IL 60527-8394 Ph: (312) 342-6066 |
| NPI Number | 1578994489 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 12/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578994489 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 036.117531 (Illinois) | Primary |
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