| Jeff Weishaar, Psy.d., P.c. | |
|
2012 Crooked Tree Ct Mchenry IL 60050-3993 | |
| (715) 864-9326 | |
| (815) 344-2448 |
| Full Name | Jeff Weishaar, Psy.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 2012 Crooked Tree Ct, Mchenry, Illinois |
| Authorized Official Name and Position | Jeff R. Weishaar (PRESIDENT) |
| Authorized Official Contact | 7158649326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff Weishaar, Psy.d., P.c. 2012 Crooked Tree Ct Mchenry IL 60050-3993 Ph: (715) 864-9326 | Jeff Weishaar, Psy.d., P.c. 2012 Crooked Tree Ct Mchenry IL 60050-3993 Ph: (715) 864-9326 |
| NPI Number | 1538482583 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 03/04/2010 |
| Medicare PECOS PAC ID | 3375679459 |
|---|---|
| Medicare Enrollment ID | O20100327000557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538482583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071007616 (Illinois) | Primary |
| Provider Name | Patricia M Koltun |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417112863 PECOS PAC ID: 7719054501 Enrollment ID: I20080919000432 |
| Provider Name | Jeffrey R Weishaar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396913927 PECOS PAC ID: 3072678739 Enrollment ID: I20090211000824 |
| Provider Name | Andrew G Beatty |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124328752 PECOS PAC ID: 8123209749 Enrollment ID: I20110301001100 |
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