Lemon, Licavoli & Associates, P.c. | |
28379 Davis Pkwy Suite 801 Warrenville IL 60555-3032 | |
(630) 393-9800 | |
(630) 393-0499 |
Full Name | Lemon, Licavoli & Associates, P.c. |
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Speciality | Psychologist |
Location | 28379 Davis Pkwy, Warrenville, Illinois |
Authorized Official Name and Position | Martin Edward Lemon (OWNER) |
Authorized Official Contact | 6303939800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lemon, Licavoli & Associates, P.c. 28379 Davis Pkwy Suite 801 Warrenville IL 60555-3032 Ph: (630) 393-9800 | Lemon, Licavoli & Associates, P.c. 28379 Davis Pkwy Suite 801 Warrenville IL 60555-3032 Ph: (630) 393-9800 |
NPI Number | 1487779468 |
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Provider Enumeration Date | 03/20/2007 |
Last Update Date | 10/06/2016 |
Medicare PECOS PAC ID | 5395894778 |
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Medicare Enrollment ID | O20090513000505 |
Identifier | Type | State | Issuer |
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1487779468 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 071-004794 (Illinois) | Primary |
Provider Name | Martin E Lemon |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1063650141 PECOS PAC ID: 4183773575 Enrollment ID: I20090513000576 |
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