| Illinois Associates Psychiatry P C | |
|
103a South Pointe Drive Edwardsville IL 62025-3780 | |
| (618) 656-2000 | |
| (618) 656-1169 |
| Full Name | Illinois Associates Psychiatry P C |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 103a South Pointe Drive, Edwardsville, Illinois |
| Authorized Official Name and Position | Kimberly Anne Stevens (OPERATIONS MANAGER) |
| Authorized Official Contact | 6184079363 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Associates Psychiatry P C Po Box 790 Edwardsville IL 62025-0790 Ph: (618) 692-9640 | Illinois Associates Psychiatry P C 103a South Pointe Drive Edwardsville IL 62025-3780 Ph: (618) 656-2000 |
| NPI Number | 1023108875 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 12/14/2015 |
| Medicare PECOS PAC ID | 4880649045 |
|---|---|
| Medicare Enrollment ID | O20050321000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023108875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 060006403 (Illinois) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 060006403 (Illinois) | Primary |
| Provider Name | Kristin L Krebs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225021033 PECOS PAC ID: 8426004458 Enrollment ID: I20050323000637 |
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