| Jaimee York Llc | |
|
6707 N Sheridan Rd Ste P Peoria IL 61614-2849 | |
| (309) 472-1651 | |
| Not Available |
| Full Name | Jaimee York Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6707 N Sheridan Rd Ste P, Peoria, Illinois |
| Authorized Official Name and Position | Jaimee M York (OWNER) |
| Authorized Official Contact | 3094721651 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaimee York Llc 1390 County Road 1000 N Lacon IL 61540-8916 Ph: (309) 472-1651 | Jaimee York Llc 6707 N Sheridan Rd Ste P Peoria IL 61614-2849 Ph: (309) 472-1651 |
| NPI Number | 1275262883 |
|---|---|
| Provider Enumeration Date | 06/08/2022 |
| Last Update Date | 05/06/2024 |
| Certification Date | 05/06/2024 |
| Medicare PECOS PAC ID | 4284167081 |
|---|---|
| Medicare Enrollment ID | O20241101000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275262883 | NPI | - | NPPES |
| Provider Name | Jaimee Marie York |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700163730 PECOS PAC ID: 5193258994 Enrollment ID: I20241101000124 |
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