Wellspring Clinical Associates, Inc. | |
5950 Lincoln Ave Unit W Lisle IL 60532-3388 | |
(630) 541-8930 | |
(630) 541-8940 |
Full Name | Wellspring Clinical Associates, Inc. |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 5950 Lincoln Ave, Lisle, Illinois |
Authorized Official Name and Position | Thomas Leo Dimatteo (PRESIDENT) |
Authorized Official Contact | 6305418930 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wellspring Clinical Associates, Inc. 5950 Lincoln Ave Unit W Lisle IL 60532-3388 Ph: (630) 541-8930 | Wellspring Clinical Associates, Inc. 5950 Lincoln Ave Unit W Lisle IL 60532-3388 Ph: (630) 541-8930 |
NPI Number | 1164562609 |
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Provider Enumeration Date | 02/07/2007 |
Last Update Date | 10/07/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164562609 | NPI | - | NPPES |
022-32842 | Other | BC/BS | |
02227624 | Other | BLUE CROSS BLUE SHIELD | |
02232842 | Other | IL | BLUE CROSS BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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