| Providence Center For Psychological Services | |
|
100 W Roosevelt Rd # B-203 Wheaton IL 60187-5260 | |
| (630) 221-0600 | |
| (630) 221-0606 |
| Full Name | Providence Center For Psychological Services |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 100 W Roosevelt Rd # B-203, Wheaton, Illinois |
| Authorized Official Name and Position | Keena Peek (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 6302210600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Center For Psychological Services 100 W Roosevelt Rd # B-203 Wheaton IL 60187-5260 Ph: (630) 221-0600 | Providence Center For Psychological Services 100 W Roosevelt Rd # B-203 Wheaton IL 60187-5260 Ph: (630) 221-0600 |
| NPI Number | 1699109587 |
|---|---|
| Provider Enumeration Date | 08/27/2013 |
| Last Update Date | 08/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699109587 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071006625 (Illinois) | Primary |
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