| Psychiatry Physicians Group Llc | |
|
2021 Midwest Rd Ste 202 Oak Brook IL 60523-1368 | |
| (331) 234-7287 | |
| (331) 204-0796 |
| Full Name | Psychiatry Physicians Group Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2021 Midwest Rd Ste 202, Oak Brook, Illinois |
| Authorized Official Name and Position | Evan Owen Foster Deranja (PARTNER) |
| Authorized Official Contact | 3312227985 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatry Physicians Group Llc 2021 Midwest Rd Ste 202 Oak Brook IL 60523-1368 Ph: (331) 234-7287 | Psychiatry Physicians Group Llc 2021 Midwest Rd Ste 202 Oak Brook IL 60523-1368 Ph: (331) 234-7287 |
| NPI Number | 1396317111 |
|---|---|
| Provider Enumeration Date | 07/12/2021 |
| Last Update Date | 06/21/2024 |
| Certification Date | 06/21/2024 |
| Medicare PECOS PAC ID | 6204231632 |
|---|---|
| Medicare Enrollment ID | O20210824002004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396317111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084B0040X | Psychiatry & Neurology - Behavioral Neurology & Neuropsychiatry | (* (Not Available)) | Primary |
| Provider Name | Manjinder Kaur Brar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174789663 PECOS PAC ID: 8325189384 Enrollment ID: I20131121001755 |
| Provider Name | Kim Nancy Duque |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851547913 PECOS PAC ID: 5294990164 Enrollment ID: I20160212000639 |
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