| Lutheran General Neurology Group | |
|
8780 W Golf Rd Suite 202 Niles IL 60714 | |
| (847) 298-4590 | |
| (847) 298-0635 |
| Full Name | Lutheran General Neurology Group |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 8780 W Golf Rd, Niles, Illinois |
| Authorized Official Name and Position | Michael Jay Wasserman (PRESIDENT) |
| Authorized Official Contact | 8472984590 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran General Neurology Group 8780 W Golf Rd #202 Niles IL 60714 Ph: (847) 298-4590 | Lutheran General Neurology Group 8780 W Golf Rd Suite 202 Niles IL 60714 Ph: (847) 298-4590 |
| NPI Number | 1528193414 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 12/13/2021 |
| Certification Date | 12/13/2021 |
| Medicare PECOS PAC ID | 5092770446 |
|---|---|
| Medicare Enrollment ID | O20041124000379 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528193414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Michael J Wasserman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326004938 PECOS PAC ID: 5294790630 Enrollment ID: I20041124000350 |
Carol A. Gilbert, Ma, Lcpc, Ncc, Mn, Rn Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 241 Golf Mill Ctr, Suite 328, Niles, IL 60714 Phone: 847-212-8305 Fax: 847-635-5621 | |
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