| E A Devassy Md And Associates Sc | |
|
16612 W 159th St Suite 204 Lockport IL 60441-8006 | |
| (815) 588-3900 | |
| (815) 588-1414 |
| Full Name | E A Devassy Md And Associates Sc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 16612 W 159th St, Lockport, Illinois |
| Authorized Official Name and Position | Lynn M Sherry (OFFICE MANAGER) |
| Authorized Official Contact | 8155883900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| E A Devassy Md And Associates Sc 16612 W 159th St Suite 204 Lockport IL 60441-8006 Ph: (815) 588-3900 | E A Devassy Md And Associates Sc 16612 W 159th St Suite 204 Lockport IL 60441-8006 Ph: (815) 588-3900 |
| NPI Number | 1306039748 |
|---|---|
| Provider Enumeration Date | 08/20/2007 |
| Last Update Date | 03/06/2013 |
| Medicare PECOS PAC ID | 4688657067 |
|---|---|
| Medicare Enrollment ID | O20040608000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306039748 | NPI | - | NPPES |
| 036063297 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036063297 (Illinois) | Primary |
| Provider Name | Elsy A Devassy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417950783 PECOS PAC ID: 3476536855 Enrollment ID: I20040609000308 |
| Provider Name | Cindy Devassy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447592019 PECOS PAC ID: 1052543766 Enrollment ID: I20200129001575 |
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