| Anderson Clinical Services Corp | |
|
16057 Dobson Ave South Holland IL 60473-1738 | |
| (708) 295-3502 | |
| Not Available |
| Full Name | Anderson Clinical Services Corp |
|---|---|
| Speciality | Social Worker |
| Location | 16057 Dobson Ave, South Holland, Illinois |
| Authorized Official Name and Position | Betsy Colvin (PRESIDENT) |
| Authorized Official Contact | 7082953502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anderson Clinical Services Corp 16057 Dobson Ave South Holland IL 60473-1738 Ph: (708) 638-9648 | Anderson Clinical Services Corp 16057 Dobson Ave South Holland IL 60473-1738 Ph: (708) 295-3502 |
| NPI Number | 1801353107 |
|---|---|
| Provider Enumeration Date | 02/23/2019 |
| Last Update Date | 11/28/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 2163835018 |
|---|---|
| Medicare Enrollment ID | O20210113002432 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801353107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Betsy H Colvin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316199474 PECOS PAC ID: 0244422855 Enrollment ID: I20101013001211 |
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