Dr Colin A Brietzke, PSY D is a
Clinical Neuropsychologist based in Oak Park, Illinois. Dr Colin A Brietzke is licensed to practice in Illinois (license number 071.008376) and his current practice location is
1011 Lake St Ste 200, Oak Park, Illinois. He can be reached at his office (for appointments etc.) via phone at
(708) 320-1441.
NPI number for Dr Colin A Brietzke is 1558626267 and his current mailing address is 1011 Lake St Ste 200, Oak Park, Illinois. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1558626267.
Healthcare Provider's Profile
| Full Name | Dr Colin A Brietzke |
|---|
| 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 | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1558626267
- Provider Enumeration Date: 07/09/2012
- Last Update Date: 05/07/2024
Medical Identifiers
Medical identifiers for Dr Colin A Brietzke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558626267 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 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 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
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
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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