| Dr Michael G Tavolacci, LPC | |
|
390 E Devon Ave Ste 201, Roselle, IL 60172-1763 | |
| (630) 358-9821 | |
| Not Available |
| Full Name | Dr Michael G Tavolacci |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 390 E Devon Ave Ste 201, Roselle, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518592872 | NPI | - | NPPES |
| Entity Name | Modern Me Psychology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841830338 PECOS PAC ID: 8820427966 Enrollment ID: O20200410001413 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael G Tavolacci, LPC 223 W Country Dr, Bartlett, IL 60103-4674 Ph: (630) 803-3591 | Dr Michael G Tavolacci, LPC 390 E Devon Ave Ste 201, Roselle, IL 60172-1763 Ph: (630) 358-9821 |
Asta Klimaite, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 975 E Nerge Rd Ste W40, Roselle, IL 60172 Phone: 708-695-4808 | |
Ms. Vicki Lee Caserno, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 975 E Nerge Rd Ste W40, Roselle, IL 60172 Phone: 708-695-4808 | |
Kristen Judith Beeck, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 390 E Devon Ave Ste 201, Roselle, IL 60172 Phone: 630-358-9821 | |
Ms. Tania Margo Gallant, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 120 Hastings Ct, Roselle, IL 60172 Phone: 224-523-3723 | |
Amanda Worth, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 390 E Devon Ave Ste 201, Roselle, IL 60172 Phone: 630-358-9821 | |
Demetria Agharese, MA, LPC Counselor Medicare: Medicare Enrolled Practice Location: 286 Regal Ct, Roselle, IL 60172 Phone: 313-377-7456 |