Axiscare Neuropsychology, Llc | |
2580 Foxfield Rd Ste 101-4 St Charles IL 60174-1403 | |
(847) 284-8133 | |
Not Available |
Full Name | Axiscare Neuropsychology, Llc |
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Speciality | Clinical Neuropsychologist |
Location | 2580 Foxfield Rd Ste 101-4, St Charles, Illinois |
Authorized Official Name and Position | Neal R Bowen (OWNER) |
Authorized Official Contact | 8472848133 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Axiscare Neuropsychology, Llc Po Box 2257 Chesterton IN 46304-0357 Ph: (219) 926-8320 | Axiscare Neuropsychology, Llc 2580 Foxfield Rd Ste 101-4 St Charles IL 60174-1403 Ph: (847) 284-8133 |
NPI Number | 1669812756 |
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Provider Enumeration Date | 07/03/2013 |
Last Update Date | 06/12/2016 |
Medicare PECOS PAC ID | 2860635513 |
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Medicare Enrollment ID | O20130827000837 |
Identifier | Type | State | Issuer |
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1669812756 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
Provider Name | Neal Ross Bowen |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1063585933 PECOS PAC ID: 2163528472 Enrollment ID: I20070503000154 |
Provider Name | Larry S Wexler |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1013030980 PECOS PAC ID: 5597897629 Enrollment ID: I20100724000237 |
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