| Shaneil Elizabeth Vance, | |
|
1750 Broadway St Trlr 3022, Blue Island, IL 60406-2780 | |
| (773) 943-0551 | |
| Not Available |
| Full Name | Shaneil Elizabeth Vance |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 7 Years |
| Location | 1750 Broadway St Trlr 3022, Blue Island, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083437677 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180016098 (Illinois) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rockford Psychiatric Medical Services Sc | 6901089515 | 109 |
| 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 |
|---|---|
| Shaneil Elizabeth Vance, 1750 Broadway St Trlr 3022, Blue Island, IL 60406-2780 Ph: (773) 943-0551 | Shaneil Elizabeth Vance, 1750 Broadway St Trlr 3022, Blue Island, IL 60406-2780 Ph: (773) 943-0551 |
Randi Coley, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12942 Page Ct, Blue Island, IL 60406 Phone: 708-593-4412 | |
Ngozi Harris, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 12510 Vincennes Rd, Unit 4, Blue Island, IL 60406 Phone: 708-691-9424 | |
Kristine Lynch, LCSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 12740 Elm St, Blue Island, IL 60406 Phone: 773-599-0802 | |
Nicole Frazier, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5827 | |
Andrea R. Boyd, MA, QMHP Counselor Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5823 Fax: 708-371-4563 | |
Melissa Coleman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 13136 Western Ave, Blue Island, IL 60406 Phone: 708-974-5849 |