| Theodore Handrup Md Ltd | |
|
2800 N Sheridan Rd Ste 502 Chicago IL 60657-6183 | |
| (773) 472-1483 | |
| Not Available |
| Full Name | Theodore Handrup Md Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2800 N Sheridan Rd Ste 502, Chicago, Illinois |
| Authorized Official Name and Position | Theodore B Handrup (PRESIDENT) |
| Authorized Official Contact | 7734721483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theodore Handrup Md Ltd 2800 N Sheridan Rd Ste 502 Chicago IL 60657-6183 Ph: (773) 472-1483 | Theodore Handrup Md Ltd 2800 N Sheridan Rd Ste 502 Chicago IL 60657-6183 Ph: (773) 472-1483 |
| NPI Number | 1235152687 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 10/27/2023 |
| Certification Date | 10/27/2023 |
| Medicare PECOS PAC ID | 5294709887 |
|---|---|
| Medicare Enrollment ID | O20040820000155 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235152687 | NPI | - | NPPES |
| 036046001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036046001 (Illinois) | Primary |
| Provider Name | Theodore B Handrup |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073594974 PECOS PAC ID: 3375517964 Enrollment ID: I20080108000627 |
| Provider Name | Lyn Scholomite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770553604 PECOS PAC ID: 8224183538 Enrollment ID: I20090909000508 |
| Provider Name | Lisa M Nagatomo Timms |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417927344 PECOS PAC ID: 5193871366 Enrollment ID: I20090914000608 |
| Provider Name | Cynthia Taylor Handrup |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1477524908 PECOS PAC ID: 5991851164 Enrollment ID: I20090914000633 |
| Provider Name | Deborah F Bump |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326385824 PECOS PAC ID: 7810134863 Enrollment ID: I20130510000082 |
| Provider Name | Surinder R Sehdev |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275896631 PECOS PAC ID: 1658673801 Enrollment ID: I20160613000916 |
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