| Psi | |
|
4324 7th St Moline IL 61265-6867 | |
| (309) 757-9000 | |
| (309) 757-9057 |
| Full Name | Psi |
|---|---|
| Speciality | Psychologist |
| Location | 4324 7th St, Moline, Illinois |
| Authorized Official Name and Position | John C Brooke (PRESIDENT) |
| Authorized Official Contact | 3097579000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psi 4324 7th St Moline IL 61265-6867 Ph: (309) 757-9000 | Psi 4324 7th St Moline IL 61265-6867 Ph: (309) 757-9000 |
| NPI Number | 1881604270 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 06/07/2012 |
| Medicare PECOS PAC ID | 1759560907 |
|---|---|
| Medicare Enrollment ID | O20110120000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881604270 | NPI | - | NPPES |
| Provider Name | John C Brooke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588662126 PECOS PAC ID: 2769499839 Enrollment ID: I20060314000731 |
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