Christine V Petersen, PSY D | |
2530 Crawford Ave Ste 212, Evanston, IL 60201-4959 | |
(773) 469-7339 | |
Not Available |
Full Name | Christine V Petersen |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 25 Years |
Location | 2530 Crawford Ave Ste 212, Evanston, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033217385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 071006311 (Illinois) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Grand Oaks Behavioral Health Llc | 2163523903 | 10 |
Entity Name | Grand Oaks Behavioral Health Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1124242359 PECOS PAC ID: 2163523903 Enrollment ID: O20070724000609 |
Mailing Address | Practice Location Address |
---|---|
Christine V Petersen, PSY D 2530 Crawford Ave Ste 212, Evanston, IL 60201-4959 Ph: (773) 469-7339 | Christine V Petersen, PSY D 2530 Crawford Ave Ste 212, Evanston, IL 60201-4959 Ph: (773) 469-7339 |
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