|
| |
|
1500 Maybrook Dr Suite 222 Maywood IL 60153-2435 | |
| (773) 674-3282 | |
| (773) 674-4913 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1500 Maybrook Dr, Maywood, Illinois |
| Authorized Official Name and Position | Reginald Stone (DEPUTY CHIEF PROBATION OFFICER) |
| Authorized Official Contact | 7736742871 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
69 W. Washington St Suite 1940 Chicago IL 60602-3035 Ph: (312) 603-0258 | 1500 Maybrook Dr Suite 222 Maywood IL 60153-2435 Ph: (773) 674-3282 |
| NPI Number | 1811279946 |
|---|---|
| Provider Enumeration Date | 09/14/2011 |
| Last Update Date | 09/21/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811279946 | NPI | - | NPPES |
| 04038 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Way Back Inn Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Oak St., Maywood, IL 60153 Phone: 708-344-3301 Fax: 708-344-2944 | |
Enhanced Clinical Solutions, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 S 1st Ave, Suite# 310, Maywood, IL 60153 Phone: 708-344-0884 Fax: 708-343-5629 | |
Proviso-leyden Council For Community Action Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 411 Madison St, Maywood, IL 60153 Phone: 708-450-3500 Fax: 708-236-5184 | |
Healthy Soul Talk Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 S 1st Ave Ste 307, Maywood, IL 60153 Phone: 708-483-8455 Fax: 708-776-4717 |