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135 N Greenleaf St Ste 120 Gurnee IL 60031-3334 | |
| (224) 430-8109 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 135 N Greenleaf St Ste 120, Gurnee, Illinois |
| Authorized Official Name and Position | Kim Barkus (PARTNER) |
| Authorized Official Contact | 2244308109 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
135 N Greenleaf St Ste 120 Gurnee IL 60031-3334 Ph: (224) 285-0728 | 135 N Greenleaf St Ste 120 Gurnee IL 60031-3334 Ph: (224) 430-8109 |
| NPI Number | 1285384248 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Medicare PECOS PAC ID | 2466984398 |
|---|---|
| Medicare Enrollment ID | O20241017000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285384248 | NPI | - | NPPES |
| 1285384248 | Medicaid | IL | |
| 342760608001 | Medicaid | IL |
| Provider Name | Kim Barkus |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912253659 PECOS PAC ID: 7719419647 Enrollment ID: I20241017000705 |
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