| Mid-america Psychiatric Consultants, Llc | |
|
2120 Madison Ave Suite 404 Granite City IL 62040 | |
| (618) 876-7515 | |
| (618) 876-7596 |
| Full Name | Mid-america Psychiatric Consultants, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2120 Madison Ave, Granite City, Illinois |
| Authorized Official Name and Position | Asif Habib (CO OWNER) |
| Authorized Official Contact | 6188767519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-america Psychiatric Consultants, Llc 2120 Madison Ave Suite 404 Granite City IL 62040 Ph: (618) 876-7515 | Mid-america Psychiatric Consultants, Llc 2120 Madison Ave Suite 404 Granite City IL 62040 Ph: (618) 876-7515 |
| NPI Number | 1750451993 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 04/20/2016 |
| Medicare PECOS PAC ID | 5890723241 |
|---|---|
| Medicare Enrollment ID | O20050728000021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750451993 | NPI | - | NPPES |
| 505200402002 | Medicaid | MO | |
| 0006030018 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jodie Lynn Warsing |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1639116767 PECOS PAC ID: 1850396821 Enrollment ID: I20060926000124 |
| Provider Name | Nigel B Darvell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568502342 PECOS PAC ID: 4183755663 Enrollment ID: I20100628000193 |
| Provider Name | Asif Habib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124000104 PECOS PAC ID: 2264449776 Enrollment ID: I20120302000111 |
| Provider Name | Arif Habib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215912977 PECOS PAC ID: 8426065939 Enrollment ID: I20121025000474 |
| Provider Name | Amanda M Hemphill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073973863 PECOS PAC ID: 2466759071 Enrollment ID: I20170321002102 |
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