| The Neurofeedback And Cognitive Training Institute Of Greater Chicago | |
|
404 W Boughton Rd Suite B Bolingbrook IL 60440-1898 | |
| (630) 759-1732 | |
| (630) 759-5220 |
| Full Name | The Neurofeedback And Cognitive Training Institute Of Greater Chicago |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 404 W Boughton Rd, Bolingbrook, Illinois |
| Authorized Official Name and Position | Marcia Susan Gibson (VICE-PRESIDENT) |
| Authorized Official Contact | 6307591732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Neurofeedback And Cognitive Training Institute Of Greater Chicago 404 W Boughton Rd Suite B Bolingbrook IL 60440-1898 Ph: (630) 759-1732 | The Neurofeedback And Cognitive Training Institute Of Greater Chicago 404 W Boughton Rd Suite B Bolingbrook IL 60440-1898 Ph: (630) 759-1732 |
| NPI Number | 1568747202 |
|---|---|
| Provider Enumeration Date | 10/13/2011 |
| Last Update Date | 10/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568747202 | NPI | - | NPPES |
| PTAN IS IL 3090 | Other | IL | MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN) IS IL3090 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 071007322 (Illinois) | Primary |
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