| Old Oak Psychological Health Center, Llc | |
|
401 E Prospect Ave Ste 218 Mt Prospect IL 60056-3396 | |
| (847) 999-3888 | |
| Not Available |
| Full Name | Old Oak Psychological Health Center, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 401 E Prospect Ave Ste 218, Mt Prospect, Illinois |
| Authorized Official Name and Position | Jeremy Luce (LICENSED CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 8479993888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Old Oak Psychological Health Center, Llc 401 E Prospect Ave Ste 218 Mt Prospect IL 60056-3396 Ph: (847) 999-3888 | Old Oak Psychological Health Center, Llc 401 E Prospect Ave Ste 218 Mt Prospect IL 60056-3396 Ph: (847) 999-3888 |
| NPI Number | 1558923789 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 10/08/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558923789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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