| Amy Fayazrad & Associates, Pc | |
|
3633 W Lake Ave Ste 306 Glenview IL 60026-5803 | |
| (760) 831-1191 | |
| Not Available |
| Full Name | Amy Fayazrad & Associates, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 3633 W Lake Ave Ste 306, Glenview, Illinois |
| Authorized Official Name and Position | Amy Fayazrad Fayazrad (PRESIDENT) |
| Authorized Official Contact | 7608311191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Fayazrad & Associates, Pc 4137 N Meade Ave Chicago IL 60634-1506 Ph: () - | Amy Fayazrad & Associates, Pc 3633 W Lake Ave Ste 306 Glenview IL 60026-5803 Ph: (760) 831-1191 |
| NPI Number | 1184147647 |
|---|---|
| Provider Enumeration Date | 07/17/2017 |
| Last Update Date | 07/17/2017 |
| Medicare PECOS PAC ID | 2163778960 |
|---|---|
| Medicare Enrollment ID | O20180710001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184147647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Amy D Fayazrad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043440910 PECOS PAC ID: 2668775479 Enrollment ID: I20160127002297 |
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