| Family Care Associates Of Bourbonnais, Inc. | |
|
750 Almar Pkwy Ste 204 Bourbonnais IL 60914-2399 | |
| (815) 214-9872 | |
| Not Available |
| Full Name | Family Care Associates Of Bourbonnais, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 750 Almar Pkwy Ste 204, Bourbonnais, Illinois |
| Authorized Official Name and Position | Benjamin Kunz (PRESIDENT) |
| Authorized Official Contact | 8152149872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Care Associates Of Bourbonnais, Inc. 750 Almar Pkwy Ste 204 Bourbonnais IL 60914-2399 Ph: (815) 214-9872 | Family Care Associates Of Bourbonnais, Inc. 750 Almar Pkwy Ste 204 Bourbonnais IL 60914-2399 Ph: (815) 214-9872 |
| NPI Number | 1396239802 |
|---|---|
| Provider Enumeration Date | 06/18/2018 |
| Last Update Date | 06/18/2018 |
| Medicare PECOS PAC ID | 6507119211 |
|---|---|
| Medicare Enrollment ID | O20181026001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396239802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071.009770 (Illinois) | Primary |
| Provider Name | Benjamin Kunz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801165147 PECOS PAC ID: 6103179320 Enrollment ID: I20181105002145 |
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