| Legacy Clinical Consultants, Llc | |
|
3033 Ogden Ave Ste 200 Lisle IL 60532-1976 | |
| (877) 443-7030 | |
| Not Available |
| Full Name | Legacy Clinical Consultants, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 3033 Ogden Ave Ste 200, Lisle, Illinois |
| Authorized Official Name and Position | Jeffrey Brian Vanmeter (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8774437030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Clinical Consultants, Llc 13300 S Route 59 Suite B-7 Plainfield IL 60585-9847 Ph: (815) 577-3666 | Legacy Clinical Consultants, Llc 3033 Ogden Ave Ste 200 Lisle IL 60532-1976 Ph: (877) 443-7030 |
| NPI Number | 1124092911 |
|---|---|
| Provider Enumeration Date | 02/16/2006 |
| Last Update Date | 04/05/2024 |
| Certification Date | 04/05/2024 |
| Medicare PECOS PAC ID | 6901865393 |
|---|---|
| Medicare Enrollment ID | O20041011000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124092911 | NPI | - | NPPES |
| 9932120 | Other | IL | BLUE CROSS BLUE SHIELD |
| Provider Name | Jeffrey B Vanmeter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336367606 PECOS PAC ID: 1355300740 Enrollment ID: I20041013001350 |
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