| Amanda M Straka, | |
|
1511 E Roosevelt Rd Apt 6, Wheaton, IL 60187-6844 | |
| (779) 717-3545 | |
| Not Available |
| Full Name | Amanda M Straka |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 1511 E Roosevelt Rd Apt 6, Wheaton, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033726864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 180016025 (Illinois) | Primary |
| Entity Name | Rockford Psychiatric Medical Services Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821391442 PECOS PAC ID: 6901089515 Enrollment ID: O20110318000777 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda M Straka, 1511 E Roosevelt Rd Apt 6, Wheaton, IL 60187-6844 Ph: (779) 717-3545 | Amanda M Straka, 1511 E Roosevelt Rd Apt 6, Wheaton, IL 60187-6844 Ph: (779) 717-3545 |
Ariana Santacruz, Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 N County Farm Rd, Wheaton, IL 60187 Phone: 630-682-7400 | |
Monique D Copprue, Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 N County Farm Rd, Wheaton, IL 60187 Phone: 630-682-7400 | |
Brendan Christopher Bell, MA LCPC Counselor Medicare: Medicare Enrolled Practice Location: 620 W Roosevelt Rd, Suite D 1, Wheaton, IL 60187 Phone: 630-462-1999 Fax: 630-462-0059 | |
Ms. Diane Johanning, M.A., LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2100 Manchester Rd Ste 900, Wheaton, IL 60187 Phone: 630-665-1255 | |
Mrs. Amy M Churchill, MS, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1616 E Roosevelt Rd, Suite 8, Wheaton, IL 60187 Phone: 630-588-1201 | |
Sergio Martinez, LSW, CADC Counselor Medicare: Accepting Medicare Assignments Practice Location: 2100 Manchester Rd Ste 1510, Wheaton, IL 60187 Phone: 630-653-1717 Fax: 630-653-9691 | |
Fallon Weatherspoon, Counselor Medicare: Not Enrolled in Medicare Practice Location: 111 N County Farm Rd, Wheaton, IL 60187 Phone: 630-682-7400 |