Northshore Integrative Healthcare | |
455 S Roselle Rd Suite 104 Schaumburg IL 60193-2971 | |
(847) 920-4644 | |
Not Available |
Full Name | Northshore Integrative Healthcare |
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Speciality | Psychologist |
Location | 455 S Roselle Rd, Schaumburg, Illinois |
Authorized Official Name and Position | Kenneth Lofland (PRESIDENT) |
Authorized Official Contact | 8479204644 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northshore Integrative Healthcare Po Box 1592 Deerfield IL 60015-6009 Ph: (847) 920-4644 | Northshore Integrative Healthcare 455 S Roselle Rd Suite 104 Schaumburg IL 60193-2971 Ph: (847) 920-4644 |
NPI Number | 1447547211 |
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Provider Enumeration Date | 06/30/2011 |
Last Update Date | 11/05/2014 |
Medicare PECOS PAC ID | 0648443051 |
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Medicare Enrollment ID | O20111031000742 |
Identifier | Type | State | Issuer |
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1447547211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Kenneth R Lofland |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1255406567 PECOS PAC ID: 6406802552 Enrollment ID: I20050322001106 |
Provider Name | Tracy Aneziris |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1912518143 PECOS PAC ID: 7618394289 Enrollment ID: I20200827000809 |
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