| B & B Spaulding Llc | |
|
20587 N Swansway Deer Park IL 60010-3768 | |
| (847) 421-0252 | |
| (847) 847-7501 |
| Full Name | B & B Spaulding Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 20587 N Swansway, Deer Park, Illinois |
| Authorized Official Name and Position | Robert Spaulding (MANAGER) |
| Authorized Official Contact | 8474210252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| B & B Spaulding Llc 20587 N Swansway Deer Park IL 60010-3768 Ph: (847) 421-0252 | B & B Spaulding Llc 20587 N Swansway Deer Park IL 60010-3768 Ph: (847) 421-0252 |
| NPI Number | 1902106750 |
|---|---|
| Provider Enumeration Date | 10/27/2010 |
| Last Update Date | 02/14/2018 |
| Medicare PECOS PAC ID | 7810177177 |
|---|---|
| Medicare Enrollment ID | O20110203001142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902106750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Barbara A Spaulding |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356574222 PECOS PAC ID: 1456531714 Enrollment ID: I20110204000252 |
| Provider Name | Diane E Petersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306187117 PECOS PAC ID: 7719121987 Enrollment ID: I20130910000804 |
| Provider Name | Sara Lynn Vasilev |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134597859 PECOS PAC ID: 1951665777 Enrollment ID: I20180502002903 |
| Provider Name | Pier London |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992347892 PECOS PAC ID: 7517386170 Enrollment ID: I20200930002950 |
| Provider Name | Mark Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366650475 PECOS PAC ID: 6305252628 Enrollment ID: I20210311002284 |
Holland Therapy Group Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20347 N Meadow Ln, Deer Park, IL 60010 Phone: 864-688-9097 |