| Illinois Geriatric Psychological Services P.c. | |
|
503 4th St Harvard IL 60033-2311 | |
| (815) 212-3209 | |
| Not Available |
| Full Name | Illinois Geriatric Psychological Services P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 503 4th St, Harvard, Illinois |
| Authorized Official Name and Position | Peter M Koehn (PRESIDENT) |
| Authorized Official Contact | 8152123209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Geriatric Psychological Services P.c. 503 4th St Harvard IL 60033-2311 Ph: () - | Illinois Geriatric Psychological Services P.c. 503 4th St Harvard IL 60033-2311 Ph: (815) 212-3209 |
| NPI Number | 1184999310 |
|---|---|
| Provider Enumeration Date | 03/21/2012 |
| Last Update Date | 03/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184999310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071007428 (Illinois) | Primary |
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