Dr Colin A Brietzke, PSY D is a medicare enrolled "Clinical Neuropsychologist" provider in Oak Park, Illinois. His current practice location is
1011 Lake St Ste 200, Oak Park, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 320-1441.
Dr Colin A Brietzke is licensed to practice in Illinois (license number 071.008376) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558626267.
Healthcare Provider's Profile
| Full Name | Dr Colin A Brietzke |
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| Gender | Male |
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| Speciality | Clinical Neuropsychologist |
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| Location | 1011 Lake St Ste 200, Oak Park, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558626267
- Provider Enumeration Date: 07/09/2012
- Last Update Date: 05/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 0749586428
- Enrollment ID: I20160307000512
Medical Identifiers
Medical identifiers for Dr Colin A Brietzke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558626267 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 071008376 (Illinois) | Secondary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 071008376 (Illinois) | Secondary |
| 103TF0200X | Psychologist - Forensic | 071.008376 (Illinois) | Secondary |
| 103G00000X | Clinical Neuropsychologist | 071.008376 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Colin A Brietzke allows following entities to bill medicare on his behalf.
| Entity Name | Chicagoland Neuropsychology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275946048
PECOS PAC ID: 6901343334
Enrollment ID: O20240802003702 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Colin A Brietzke is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Colin A Brietzke, PSY D
1011 Lake St Ste 200,
Oak Park, IL 60301-1137
Ph: (708) 320-1411 | Dr Colin A Brietzke, PSY D
1011 Lake St Ste 200,
Oak Park, IL 60301-1137
Ph: (708) 320-1441 |
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