| Roueen Rafeyan Md Ltd | |
|
4455 S King Dr #101 Chicago IL 60653-3310 | |
| (847) 251-2067 | |
| (847) 251-2104 |
| Full Name | Roueen Rafeyan Md Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4455 S King Dr, Chicago, Illinois |
| Authorized Official Name and Position | Roueen Rafeyan (OWNER) |
| Authorized Official Contact | 8474330057 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roueen Rafeyan Md Ltd Po Box 258 Kenilworth IL 60043-0258 Ph: (847) 251-2067 | Roueen Rafeyan Md Ltd 4455 S King Dr #101 Chicago IL 60653-3310 Ph: (847) 251-2067 |
| NPI Number | 1508048414 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 12/19/2012 |
| Medicare PECOS PAC ID | 5092603027 |
|---|---|
| Medicare Enrollment ID | O20040310000225 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508048414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036089152 (Illinois) | Primary |
| Provider Name | Roueen Rafeyan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003891458 PECOS PAC ID: 5991693921 Enrollment ID: I20040601001325 |
| Provider Name | Mojgan Makki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366428328 PECOS PAC ID: 1850356296 Enrollment ID: I20091113000167 |
| Provider Name | Erin M Petrusic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124432497 PECOS PAC ID: 8325366867 Enrollment ID: I20150414001434 |
| Provider Name | Melissa Vitale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952867681 PECOS PAC ID: 1153664149 Enrollment ID: I20190514002587 |
| Provider Name | Sarah Bier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962920884 PECOS PAC ID: 8123386646 Enrollment ID: I20240306001745 |
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