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175 E Hawthorn Pkwy Suite 235 Vernon Hills IL 60061-1463 | |
| (847) 868-3435 | |
| (847) 859-5885 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 175 E Hawthorn Pkwy, Vernon Hills, Illinois |
| Authorized Official Name and Position | Jeremy Warner (PRACTICE MANAGER) |
| Authorized Official Contact | 8478683435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
175 E Hawthorn Pkwy Suite 235 Vernon Hills IL 60061-1463 Ph: (847) 868-3435 | 175 E Hawthorn Pkwy Suite 235 Vernon Hills IL 60061-1463 Ph: (847) 868-3435 |
| NPI Number | 1235430612 |
|---|---|
| Provider Enumeration Date | 11/16/2010 |
| Last Update Date | 09/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235430612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 071007099 (Illinois) | Primary |
| 133V00000X | Dietitian, Registered | 164005333 (Illinois) | Secondary |
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