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708 Church St Suite 216 Evanston IL 60201-3875 | |
| (847) 864-4744 | |
| (847) 864-9523 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 708 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Nicholas Dunkas (OWNER) |
| Authorized Official Contact | 8478644744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
708 Church St Suite 216 Evanston IL 60201-3875 Ph: (847) 864-4744 | 708 Church St Suite 216 Evanston IL 60201-3875 Ph: (847) 864-4744 |
| NPI Number | 1366563256 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 0648364604 |
|---|---|
| Medicare Enrollment ID | O20070920000801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366563256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084A0401X | Psychiatry & Neurology - Addiction Medicine | (Illinois) | Primary |
| Provider Name | Peter T Hsin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811197940 PECOS PAC ID: 4688768641 Enrollment ID: I20070920000857 |
| Provider Name | Martin J Mccarthy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588891592 PECOS PAC ID: 2769516038 Enrollment ID: I20100823000617 |
| Provider Name | John Koh |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720453160 PECOS PAC ID: 1951650779 Enrollment ID: I20180827003450 |
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