| Wis-per Psychiatric Services S.c. | |
|
16233 Wausau Ave South Holland IL 60473-2157 | |
| (708) 643-1753 | |
| (708) 418-0620 |
| Full Name | Wis-per Psychiatric Services S.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 16233 Wausau Ave, South Holland, Illinois |
| Authorized Official Name and Position | Rita Maria Lewis-perry (PRESIDENT) |
| Authorized Official Contact | 7082961759 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wis-per Psychiatric Services S.c. 16233 Wausau Ave South Holland IL 60473-2157 Ph: (708) 643-1753 | Wis-per Psychiatric Services S.c. 16233 Wausau Ave South Holland IL 60473-2157 Ph: (708) 643-1753 |
| NPI Number | 1306090691 |
|---|---|
| Provider Enumeration Date | 11/12/2008 |
| Last Update Date | 11/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306090691 | NPI | - | NPPES |
| 036084974 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036-084974 (Illinois) | Primary |
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