| Psychiatric Clinics Of Northern Illinois Pc | |
|
1639 N Alpine Rd Rockford IL 61107-1449 | |
| (815) 229-7227 | |
| (815) 229-7288 |
| Full Name | Psychiatric Clinics Of Northern Illinois Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1639 N Alpine Rd, Rockford, Illinois |
| Authorized Official Name and Position | Sam Azar (OFFICE MANAGER) |
| Authorized Official Contact | 8152297227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Clinics Of Northern Illinois Pc 1639 N Alpine Rd Rockford IL 61107-1449 Ph: (815) 229-7227 | Psychiatric Clinics Of Northern Illinois Pc 1639 N Alpine Rd Rockford IL 61107-1449 Ph: (815) 229-7227 |
| NPI Number | 1679605737 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 07/01/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679605737 | NPI | - | NPPES |
| 0010100667 | Other | IL | BCBS OF ILLINOIS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036079335 (Illinois) | Primary |
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