| Novo: Renewing Joy In Life, Pc | |
|
104 S 2nd Ave Saint Charles IL 60174-1932 | |
| (630) 297-3617 | |
| Not Available |
| Full Name | Novo: Renewing Joy In Life, Pc |
|---|---|
| Speciality | Counselor |
| Location | 104 S 2nd Ave, Saint Charles, Illinois |
| Authorized Official Name and Position | Vicki Alden (OWNER) |
| Authorized Official Contact | 3123053443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Novo: Renewing Joy In Life, Pc 104 S 2nd Ave Saint Charles IL 60174-1932 Ph: (630) 297-3617 | Novo: Renewing Joy In Life, Pc 104 S 2nd Ave Saint Charles IL 60174-1932 Ph: (630) 297-3617 |
| NPI Number | 1669744405 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 08/08/2013 |
| Medicare PECOS PAC ID | 6305006495 |
|---|---|
| Medicare Enrollment ID | O20120327000873 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669744405 | NPI | - | NPPES |
| Provider Name | Vicki R Grunnet Alden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114080686 PECOS PAC ID: 1456243047 Enrollment ID: I20040329000095 |
| Provider Name | Judy Christine Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578879730 PECOS PAC ID: 4587844311 Enrollment ID: I20110210000488 |
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