| Alexander Chacko, LCSW, MS, PHD | |
|
104 E Queenwood Rd, Suite 203, Morton, IL 61550-2949 | |
| (309) 263-4244 | |
| Not Available |
| Full Name | Alexander Chacko |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 104 E Queenwood Rd, Morton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417901620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | IL149009399 (Illinois) | Primary |
| Entity Name | Deer Oaks Mid-west Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154978476 PECOS PAC ID: 2264762681 Enrollment ID: O20190927002974 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexander Chacko, LCSW, MS, PHD 104 E Queenwood Rd, Suite 203, Morton, IL 61550-2949 Ph: (309) 263-4244 | Alexander Chacko, LCSW, MS, PHD 104 E Queenwood Rd, Suite 203, Morton, IL 61550-2949 Ph: (309) 263-4244 |
Victoria L Mitchell, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 75 E Queenwood Rd, Morton, IL 61550 Phone: 309-263-5565 Fax: 309-263-9336 | |
Kathy Knochel, M.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 515 E Highland St, Morton, IL 61550 Phone: 093-263-5536 | |
Alyssa Graham, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 75 E Queenwood Rd, Morton, IL 61550 Phone: 309-263-5565 Fax: 309-263-9336 | |
Amber Miller, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 515 E Highland St, Morton, IL 61550 Phone: 309-263-5536 | |
Mr. Darin Scott Hoffmire, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2401 South Fourth Street, Morton, IL 61550 Phone: 309-266-6429 | |
Mrs. Stacey Lane Reeder, M.S.S.A., L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 75 E Queenwood Rd, Morton, IL 61550 Phone: 309-263-5565 |