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14 Health Services Drive Dekalb IL 60115 | |
| (815) 758-8616 | |
| (815) 758-7569 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 14 Health Services Drive, Dekalb, Illinois |
| Authorized Official Name and Position | David C Miller (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8157588616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
14 Health Services Drive Dekalb IL 60115 Ph: (815) 758-8616 | 14 Health Services Drive Dekalb IL 60115 Ph: (815) 758-8616 |
| NPI Number | 1598820300 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 07/02/2013 |
| Medicare PECOS PAC ID | 2264492669 |
|---|---|
| Medicare Enrollment ID | O20041011000510 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598820300 | NPI | - | NPPES |
| Provider Name | Daniel Klein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235288598 PECOS PAC ID: 0244471324 Enrollment ID: I20130801000488 |
| Provider Name | Tina Mccue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902416852 PECOS PAC ID: 3072045848 Enrollment ID: I20241017002649 |
| Provider Name | Ashley Hernandez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043835598 PECOS PAC ID: 2567997893 Enrollment ID: I20241125000165 |
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