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18501 Maple Creek Dr Ste 150 Tinley Park IL 60477-6783 | |
| (708) 477-7083 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 18501 Maple Creek Dr Ste 150, Tinley Park, Illinois |
| Authorized Official Name and Position | Rosalynn J Anderson (PSYCHIATRIC NURSE PRACTIONER) |
| Authorized Official Contact | 7082993056 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
18501 Maple Creek Dr Ste 150 Tinley Park IL 60477-6783 Ph: (708) 477-7083 | 18501 Maple Creek Dr Ste 150 Tinley Park IL 60477-6783 Ph: (708) 477-7083 |
| NPI Number | 1255045860 |
|---|---|
| Provider Enumeration Date | 01/09/2023 |
| Last Update Date | 08/08/2023 |
| Certification Date | 08/08/2023 |
| Medicare PECOS PAC ID | 6204297294 |
|---|---|
| Medicare Enrollment ID | O20230808000656 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255045860 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Rosalynn J Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689188526 PECOS PAC ID: 9638335219 Enrollment ID: I20180110002669 |
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