| Transformations | |
|
420 Lake Cook Rd Suite 113 Deerfield IL 60015-5646 | |
| (847) 405-0220 | |
| (847) 405-0215 |
| Full Name | Transformations |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 420 Lake Cook Rd, Deerfield, Illinois |
| Authorized Official Name and Position | Susan Cheryl Jaksa (PARTNER) |
| Authorized Official Contact | 8474050220 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transformations 420 Lake Cook Rd Suite 113 Deerfield IL 60015-5646 Ph: (847) 405-0220 | Transformations 420 Lake Cook Rd Suite 113 Deerfield IL 60015-5646 Ph: (847) 405-0220 |
| NPI Number | 1407903909 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407903909 | NPI | - | NPPES |
| 04972104 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 073000052 (Illinois) | Primary |
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