| Iag Behavioral Health Center | |
|
30 Phelps Ave Romeoville IL 60446-1335 | |
| (815) 372-8950 | |
| (815) 372-8960 |
| Full Name | Iag Behavioral Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 30 Phelps Ave, Romeoville, Illinois |
| Authorized Official Name and Position | David Heber Brooks (COO) |
| Authorized Official Contact | 6307590201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iag Behavioral Health Center 1289 Windham Pkwy Romeoville IL 60446-1763 Ph: (630) 759-0201 | Iag Behavioral Health Center 30 Phelps Ave Romeoville IL 60446-1335 Ph: (815) 372-8950 |
| NPI Number | 1801477799 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/20/2023 |
| Medicare PECOS PAC ID | 4284080243 |
|---|---|
| Medicare Enrollment ID | O20231026002852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801477799 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Shannon Warnicki |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275970808 PECOS PAC ID: 1456707413 Enrollment ID: I20231110000371 |
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