| Genesis Clinical Services | |
|
1725 S Naperville Rd Suite 206 Wheaton IL 60187-8155 | |
| (630) 653-6441 | |
| (630) 653-8409 |
| Full Name | Genesis Clinical Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 1725 S Naperville Rd, Wheaton, Illinois |
| Authorized Official Name and Position | Ralph M Orland (PRESIDENT) |
| Authorized Official Contact | 6306536441 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Clinical Services 1725 S Naperville Rd Suite 206 Wheaton IL 60187-8155 Ph: (630) 653-6441 | Genesis Clinical Services 1725 S Naperville Rd Suite 206 Wheaton IL 60187-8155 Ph: (630) 653-6441 |
| NPI Number | 1265432140 |
|---|---|
| Provider Enumeration Date | 07/21/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9739153347 |
|---|---|
| Medicare Enrollment ID | O20040820000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265432140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (Illinois) | Primary |
| Provider Name | Angelos Halaris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891762621 PECOS PAC ID: 3678471968 Enrollment ID: I20031223000597 |
| Provider Name | Emma Ab Cabusao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417911744 PECOS PAC ID: 2769465376 Enrollment ID: I20040626000025 |
| Provider Name | Gautam Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750345831 PECOS PAC ID: 6103856406 Enrollment ID: I20050816001142 |
| Provider Name | Michael A Kuna |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1750345872 PECOS PAC ID: 3072587682 Enrollment ID: I20060207000082 |
| Provider Name | Doris M Van Byssum |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063515369 PECOS PAC ID: 9931294931 Enrollment ID: I20071005000458 |
| Provider Name | Steven M Prinz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992769012 PECOS PAC ID: 0446224059 Enrollment ID: I20101217000892 |
| Provider Name | Theresa E Towle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639486137 PECOS PAC ID: 0648468207 Enrollment ID: I20101223000043 |
| Provider Name | Ralph M Orland |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265496681 PECOS PAC ID: 4981678596 Enrollment ID: I20110308000467 |
| Provider Name | Jennifer L Schuler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104880293 PECOS PAC ID: 1052593340 Enrollment ID: I20110308000506 |
| Provider Name | Doris M Van Byssum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063515369 PECOS PAC ID: 9931294931 Enrollment ID: I20160210001934 |
| Provider Name | Dana R Morton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356541221 PECOS PAC ID: 9436334224 Enrollment ID: I20160627000190 |
| Provider Name | Maryellen Fleming-price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114383213 PECOS PAC ID: 5597068163 Enrollment ID: I20160728001465 |
| Provider Name | Sharon S Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821161886 PECOS PAC ID: 8729092523 Enrollment ID: I20161025002490 |
| Provider Name | Arturo D Ventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891220257 PECOS PAC ID: 8628347846 Enrollment ID: I20170703000850 |
| Provider Name | Donald Romano |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205306529 PECOS PAC ID: 4183964794 Enrollment ID: I20190319000271 |
| Provider Name | Gena Ann Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1255984746 PECOS PAC ID: 0648508127 Enrollment ID: I20190821002901 |
| Provider Name | Jeselle V Santiago |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821754839 PECOS PAC ID: 1052701638 Enrollment ID: I20211214002538 |
| Provider Name | Shannon Lauf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194455253 PECOS PAC ID: 9335512847 Enrollment ID: I20230303001593 |
| Provider Name | Linda Madsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114984002 PECOS PAC ID: 1355780495 Enrollment ID: I20240422002461 |
| Provider Name | Osvaldo Garcia |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1245664861 PECOS PAC ID: 3173065240 Enrollment ID: I20240604002343 |
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