| Jason Soriano, Psy.d., P.c. | |
|
973 Featherstone Rd Ste 360 Rockford IL 61107-5908 | |
| (815) 520-0927 | |
| (815) 345-2162 |
| Full Name | Jason Soriano, Psy.d., P.c. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 973 Featherstone Rd Ste 360, Rockford, Illinois |
| Authorized Official Name and Position | Jason Soriano (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8155200927 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Soriano, Psy.d., P.c. 973 Featherstone Rd Ste 360 Rockford IL 61107-5908 Ph: (815) 520-0927 | Jason Soriano, Psy.d., P.c. 973 Featherstone Rd Ste 360 Rockford IL 61107-5908 Ph: (815) 520-0927 |
| NPI Number | 1588049274 |
|---|---|
| Provider Enumeration Date | 07/23/2015 |
| Last Update Date | 01/04/2023 |
| Certification Date | 01/04/2023 |
| Medicare PECOS PAC ID | 0042592040 |
|---|---|
| Medicare Enrollment ID | O20170127000984 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588049274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 071009069 (Illinois) | Primary |
| Provider Name | Jason R Soriano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275920969 PECOS PAC ID: 8022338490 Enrollment ID: I20150526002590 |
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