| Proactive Behavioral Services, Inc. | |
|
1644 W. Colonial Pkwy. Inverness IL 60067-1207 | |
| (847) 776-4500 | |
| (847) 776-4724 |
| Full Name | Proactive Behavioral Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1644 W. Colonial Pkwy., Inverness, Illinois |
| Authorized Official Name and Position | Todd R. Lendvay (PRESIDENT/OWNER) |
| Authorized Official Contact | 8477784500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Behavioral Services, Inc. 1644 W. Colonial Pkwy. Inverness IL 60067-1207 Ph: (847) 776-4500 | Proactive Behavioral Services, Inc. 1644 W. Colonial Pkwy. Inverness IL 60067-1207 Ph: (847) 776-4500 |
| NPI Number | 1043437049 |
|---|---|
| Provider Enumeration Date | 04/19/2007 |
| Last Update Date | 05/06/2011 |
| Medicare PECOS PAC ID | 7618048950 |
|---|---|
| Medicare Enrollment ID | O20080614000036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043437049 | NPI | - | NPPES |
| 04932629 | Other | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071--007171 (Illinois) | Primary |
| Provider Name | William F Puga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427011170 PECOS PAC ID: 1658331202 Enrollment ID: I20041101000934 |
| Provider Name | Todd R Lendvay |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417010687 PECOS PAC ID: 8628149960 Enrollment ID: I20080614000032 |
| Provider Name | Marc I Oster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114069093 PECOS PAC ID: 2769549633 Enrollment ID: I20090319000499 |
| Provider Name | Andres Acosta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891881843 PECOS PAC ID: 4385771484 Enrollment ID: I20100421000752 |
| Provider Name | Lorna M Rivera |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730197906 PECOS PAC ID: 3577731447 Enrollment ID: I20110720000141 |
| Provider Name | Mary B Gamlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457805541 PECOS PAC ID: 8123305612 Enrollment ID: I20170510002616 |
| Provider Name | Mazhar Khan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598229189 PECOS PAC ID: 9436483633 Enrollment ID: I20190621000999 |
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