| New Age Services Corporation | |
|
386 N York St Elmhurst IL 60126-2363 | |
| (630) 501-1742 | |
| (773) 542-1175 |
| Full Name | New Age Services Corporation |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 386 N York St, Elmhurst, Illinois |
| Authorized Official Name and Position | Ulysses Jerome Jefferson (PATIENT REVENUE COORDINATOR) |
| Authorized Official Contact | 7735421150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Age Services Corporation 386 N York St Elmhurst IL 60126-2363 Ph: (630) 501-1742 | New Age Services Corporation 386 N York St Elmhurst IL 60126-2363 Ph: (630) 501-1742 |
| NPI Number | 1073023149 |
|---|---|
| Provider Enumeration Date | 10/03/2017 |
| Last Update Date | 12/20/2022 |
| Certification Date | 12/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073023149 | NPI | - | NPPES |
| 333304755-60623-01 | Medicaid | IL |
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