| Alliance Clinical Associates Sc | |
|
7 Blanchard Cir Suite 201 Wheaton IL 60189-2039 | |
| (630) 653-2300 | |
| (630) 653-2895 |
| Full Name | Alliance Clinical Associates Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7 Blanchard Cir, Wheaton, Illinois |
| Authorized Official Name and Position | Kenneth P Phillips (PRESIDENT) |
| Authorized Official Contact | 6306532300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alliance Clinical Associates Sc 7 Blanchard Cir Suite 201 Wheaton IL 60189-2039 Ph: (630) 653-2300 | Alliance Clinical Associates Sc 7 Blanchard Cir Suite 201 Wheaton IL 60189-2039 Ph: (630) 653-2300 |
| NPI Number | 1144299769 |
|---|---|
| Provider Enumeration Date | 03/16/2006 |
| Last Update Date | 08/23/2010 |
| Medicare PECOS PAC ID | 0143202572 |
|---|---|
| Medicare Enrollment ID | O20040805000281 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144299769 | NPI | - | NPPES |
| 02215643 | Other | IL | BLUE CROSS |
| Provider Name | Wanda Grant |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538368444 PECOS PAC ID: 5294720199 Enrollment ID: I20040420000639 |
| Provider Name | Gregory N Lewis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063471027 PECOS PAC ID: 9638150311 Enrollment ID: I20040527001150 |
| Provider Name | Elliott H Pae |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497724710 PECOS PAC ID: 7517938129 Enrollment ID: I20040805000303 |
| Provider Name | Kenneth Paul Phillips |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538138748 PECOS PAC ID: 8921080367 Enrollment ID: I20100818001175 |
| Provider Name | Robert P Marseille |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053568766 PECOS PAC ID: 2567640956 Enrollment ID: I20110707000672 |
| Provider Name | Richard P Wolff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972562718 PECOS PAC ID: 0749453819 Enrollment ID: I20111105000037 |
| Provider Name | Lyndon Villasenor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205092764 PECOS PAC ID: 2961642434 Enrollment ID: I20131211001952 |
| Provider Name | Michael Yc Tso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578592184 PECOS PAC ID: 0648315655 Enrollment ID: I20190924001608 |
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