| Rayo Counseling And Community Co-op | |
|
2714 W Peterson Ave Chicago IL 60659-3920 | |
| (336) 949-7492 | |
| Not Available |
| Full Name | Rayo Counseling And Community Co-op |
|---|---|
| Speciality | Clinic/Center |
| Location | 2714 W Peterson Ave, Chicago, Illinois |
| Authorized Official Name and Position | Lauren Hersch (PRESIDENT) |
| Authorized Official Contact | 4153289443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rayo Counseling And Community Co-op 2714 W Peterson Ave Chicago IL 60659-3920 Ph: () - | Rayo Counseling And Community Co-op 2714 W Peterson Ave Chicago IL 60659-3920 Ph: (336) 949-7492 |
| NPI Number | 1750086781 |
|---|---|
| Provider Enumeration Date | 03/31/2023 |
| Last Update Date | 09/19/2024 |
| Certification Date | 09/19/2024 |
| Medicare PECOS PAC ID | 0345602454 |
|---|---|
| Medicare Enrollment ID | O20230821002971 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750086781 | NPI | - | NPPES |
| Provider Name | Elise Joelle Johnston Dumerauf |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508348343 PECOS PAC ID: 2668876533 Enrollment ID: I20210814000200 |
| Provider Name | Andrew S Hodge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497331565 PECOS PAC ID: 7012305527 Enrollment ID: I20211102000848 |
| Provider Name | Felix Acuna Olivos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124670229 PECOS PAC ID: 5890189088 Enrollment ID: I20220304000856 |
| Provider Name | Lauren Hersch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104308964 PECOS PAC ID: 5991181794 Enrollment ID: I20221003000267 |
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