| Nica | |
|
600 Spring Hill Ring Rd Ste 116 West Dundee IL 60118-7301 | |
| (815) 455-6736 | |
| (815) 455-9477 |
| Full Name | Nica |
|---|---|
| Speciality | Psychologist |
| Location | 600 Spring Hill Ring Rd Ste 116, West Dundee, Illinois |
| Authorized Official Name and Position | Cynthia Gelman (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 8154556736 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nica 600 Spring Hill Ring Rd Ste 116 West Dundee IL 60118-7301 Ph: (815) 455-6736 | Nica 600 Spring Hill Ring Rd Ste 116 West Dundee IL 60118-7301 Ph: (815) 455-6736 |
| NPI Number | 1689862807 |
|---|---|
| Provider Enumeration Date | 10/12/2007 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Medicare PECOS PAC ID | 2365404944 |
|---|---|
| Medicare Enrollment ID | O20060130000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689862807 | NPI | - | NPPES |
| 0005615149 | Other | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071-004053 (Illinois) | Primary |
| 103TC0700X | Psychologist - Clinical | 071-003663 (Illinois) | Secondary |
| Provider Name | Glenn B Gelman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487736690 PECOS PAC ID: 7315909892 Enrollment ID: I20101210000428 |
| Provider Name | Larry B Gelman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902988215 PECOS PAC ID: 3779545256 Enrollment ID: I20110111000383 |
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