| Neurorehab Psychology Consultants, Llc | |
|
419 Center St Ste C Grayslake IL 60030-1645 | |
| (262) 412-7302 | |
| Not Available |
| Full Name | Neurorehab Psychology Consultants, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 419 Center St Ste C, Grayslake, Illinois |
| Authorized Official Name and Position | Danielle M Ciccone-coutre (CLINICAL PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 2624127302 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurorehab Psychology Consultants, Llc 11314 E Riviera Dr Spring Grove IL 60081-8146 Ph: (262) 412-7302 | Neurorehab Psychology Consultants, Llc 419 Center St Ste C Grayslake IL 60030-1645 Ph: (262) 412-7302 |
| NPI Number | 1245742865 |
|---|---|
| Provider Enumeration Date | 11/05/2017 |
| Last Update Date | 04/26/2018 |
| Medicare PECOS PAC ID | 5698039733 |
|---|---|
| Medicare Enrollment ID | O20180426000674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245742865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | 071.009251 (Illinois) | Primary |
| Provider Name | Danielle Marie Ciccone |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184085573 PECOS PAC ID: 3577861327 Enrollment ID: I20160412002370 |
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