| Mark Langgut Pc | |
|
180 N Michigan Ave Suite 340 Chicago IL 60601-7401 | |
| (708) 955-3272 | |
| (708) 386-6251 |
| Full Name | Mark Langgut Pc |
|---|---|
| Speciality | Psychologist |
| Location | 180 N Michigan Ave, Chicago, Illinois |
| Authorized Official Name and Position | Mark B. Langgut (PRESIDENT) |
| Authorized Official Contact | 7089553272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Langgut Pc 180 N Michigan Ave Suite 340 Chicago IL 60601-7401 Ph: (708) 955-3272 | Mark Langgut Pc 180 N Michigan Ave Suite 340 Chicago IL 60601-7401 Ph: (708) 955-3272 |
| NPI Number | 1043581739 |
|---|---|
| Provider Enumeration Date | 01/26/2012 |
| Last Update Date | 01/29/2012 |
| Medicare PECOS PAC ID | 1658538616 |
|---|---|
| Medicare Enrollment ID | O20120202000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043581739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 071003953 (Illinois) | Primary |
| Provider Name | Mark B Langgut |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174610893 PECOS PAC ID: 8325093073 Enrollment ID: I20050316000300 |
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