| Specialized Forensic Unit Pc | |
|
555 S Randall Rd Ste 204 St Charles IL 60174-5918 | |
| (312) 818-9300 | |
| Not Available |
| Full Name | Specialized Forensic Unit Pc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 555 S Randall Rd Ste 204, St Charles, Illinois |
| Authorized Official Name and Position | Tetyana Kostyshyna (PSYCHOLOGIST, MANAGER) |
| Authorized Official Contact | 3128189300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialized Forensic Unit Pc 555 S Randall Rd Ste 204 St Charles IL 60174-5918 Ph: (312) 818-9300 | Specialized Forensic Unit Pc 555 S Randall Rd Ste 204 St Charles IL 60174-5918 Ph: (312) 818-9300 |
| NPI Number | 1396283768 |
|---|---|
| Provider Enumeration Date | 02/06/2017 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396283768 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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