| Camelot Care Centers, Llc | |
|
4747 Lincoln Mall Dr Ste 305 Matteson IL 60443-3814 | |
| (708) 747-7250 | |
| (708) 647-7258 |
| Full Name | Camelot Care Centers, Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 4747 Lincoln Mall Dr Ste 305, Matteson, Illinois |
| Authorized Official Name and Position | Ronica R Patel (STATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6307731985 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Camelot Care Centers, Llc 333 W Pierce Rd Ste 175 Itasca IL 60143-3120 Ph: (708) 747-7250 | Camelot Care Centers, Llc 4747 Lincoln Mall Dr Ste 305 Matteson IL 60443-3814 Ph: (708) 747-7250 |
| NPI Number | 1710217336 |
|---|---|
| Provider Enumeration Date | 01/04/2010 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710217336 | NPI | - | NPPES |
| 2B05-IPI-141 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
Sertoma Centre, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 4331 Lincoln Hwy, Suite A, Matteson, IL 60443 Phone: 708-748-1951 Fax: 708-748-1962 | |
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