Patricia Kimbel Psyd Pc | |
1580 S Milwaukee Ave Ste 309 Libertyville IL 60048-3773 | |
(773) 490-7778 | |
Not Available |
Full Name | Patricia Kimbel Psyd Pc |
---|---|
Speciality | Psychologist |
Location | 1580 S Milwaukee Ave Ste 309, Libertyville, Illinois |
Authorized Official Name and Position | Patricia Kimbel (PRESIDENT) |
Authorized Official Contact | 7734907778 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Patricia Kimbel Psyd Pc 3854 N Ridgeway Ave Chicago IL 60618-4014 Ph: (773) 490-7778 | Patricia Kimbel Psyd Pc 1580 S Milwaukee Ave Ste 309 Libertyville IL 60048-3773 Ph: (773) 490-7778 |
NPI Number | 1215696752 |
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Provider Enumeration Date | 12/13/2021 |
Last Update Date | 12/13/2021 |
Certification Date | 12/13/2021 |
Medicare PECOS PAC ID | 9436532959 |
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Medicare Enrollment ID | O20220817000052 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215696752 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Patricia K Kimbel |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790707610 PECOS PAC ID: 8628036506 Enrollment ID: I20041222000819 |
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