| Autism Home Support Services, Inc | |
|
85 Revere Dr Ste Aa Northbrook IL 60062-8001 | |
| (844) 247-7222 | |
| (847) 584-2604 |
| Full Name | Autism Home Support Services, Inc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 85 Revere Dr Ste Aa, Northbrook, Illinois |
| Authorized Official Name and Position | Julie Bush (CREDENTIALING MANAGER) |
| Authorized Official Contact | 8475842604 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Home Support Services, Inc Po Box 639561 Cincinnati OH 45263-9561 Ph: (844) 247-7222 | Autism Home Support Services, Inc 85 Revere Dr Ste Aa Northbrook IL 60062-8001 Ph: (844) 247-7222 |
| NPI Number | 1770818841 |
|---|---|
| Provider Enumeration Date | 10/07/2009 |
| Last Update Date | 09/08/2022 |
| Certification Date | 09/08/2022 |
| Medicare PECOS PAC ID | 5496174369 |
|---|---|
| Medicare Enrollment ID | O20200925000711 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770818841 | NPI | - | NPPES |
| Provider Name | Reema Shah |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1528678570 PECOS PAC ID: 3971922683 Enrollment ID: I20200930000819 |
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