| Neurobehavioral Group Pc | |
|
1755 Park St #200 Naperville IL 60563-4861 | |
| (630) 449-4270 | |
| (630) 820-2358 |
| Full Name | Neurobehavioral Group Pc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1755 Park St, Naperville, Illinois |
| Authorized Official Name and Position | Michelle R Myers (OWNER) |
| Authorized Official Contact | 7739724248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurobehavioral Group Pc 1755 Park St #200 Naperville IL 60563-4861 Ph: (630) 449-4270 | Neurobehavioral Group Pc 1755 Park St #200 Naperville IL 60563-4861 Ph: (630) 449-4270 |
| NPI Number | 1992051130 |
|---|---|
| Provider Enumeration Date | 07/25/2012 |
| Last Update Date | 11/01/2013 |
| Medicare PECOS PAC ID | 7315182870 |
|---|---|
| Medicare Enrollment ID | O20210512000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992051130 | NPI | - | NPPES |
| IL8063 | Other | IL | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 071007744 (Illinois) | Primary |
| 103TC0700X | Psychologist - Clinical | 071007744 (Illinois) | Secondary |
| Provider Name | Michelle R Myers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336472943 PECOS PAC ID: 0143361394 Enrollment ID: I20210513000226 |
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