| Innovative Behavioral Health, P.c. | |
|
800 W 5th Ave #205g Naperville IL 60563-8965 | |
| (630) 913-7045 | |
| Not Available |
| Full Name | Innovative Behavioral Health, P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 800 W 5th Ave, Naperville, Illinois |
| Authorized Official Name and Position | Christian Robert Locke (PRESIDENT) |
| Authorized Official Contact | 6309137045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Behavioral Health, P.c. 705 N Sparkle Ct Oswego IL 60543-7942 Ph: (630) 913-7045 | Innovative Behavioral Health, P.c. 800 W 5th Ave #205g Naperville IL 60563-8965 Ph: (630) 913-7045 |
| NPI Number | 1730295841 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7911904503 |
|---|---|
| Medicare Enrollment ID | O20061024000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730295841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
| Provider Name | Christian R Locke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407949720 PECOS PAC ID: 6002813607 Enrollment ID: I20061024000299 |
| Provider Name | Veronica T Lickfelt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083925762 PECOS PAC ID: 6901089655 Enrollment ID: I20110318000048 |
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