|
| |
|
671 S Lewis Ave Waukegan IL 60085-6101 | |
| (847) 782-4154 | |
| (847) 782-1030 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 671 S Lewis Ave, Waukegan, Illinois |
| Authorized Official Name and Position | Michael M Boland (ADMINISTRATOR, PRESIDENT AND CEO) |
| Authorized Official Contact | 3126557320 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
671 S Lewis Ave Waukegan IL 60085-6101 Ph: (847) 782-4154 | 671 S Lewis Ave Waukegan IL 60085-6101 Ph: (847) 782-4154 |
| NPI Number | 1295154813 |
|---|---|
| Provider Enumeration Date | 04/10/2014 |
| Last Update Date | 12/28/2023 |
| Certification Date | 05/12/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295154813 | NPI | - | NPPES |
| 04019 | Medicaid | IL |
Cognitive Pathways Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Washington St, Suite 403, Waukegan, IL 60085 Phone: 224-733-1615 Fax: 224-733-1620 | |
Truth Youth & Family Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2504 Washington St., 300 B/c, Waukegan, IL 60085 Phone: 224-489-7773 | |
The Josselyn Center Nfp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 N Genesee St, Waukegan, IL 60085 Phone: 847-441-5600 Fax: 847-441-7698 | |
Arden Shore Child And Family Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2504 Washington St, Suite 200, Waukegan, IL 60085 Phone: 847-662-4464 Fax: 847-662-4530 |