| Illinois Center For Neurological And Behavioral Medicine Ltd | |
|
1455 E Golf Rd Ste 207 Des Plaines IL 60016-1254 | |
| (312) 649-5829 | |
| Not Available |
| Full Name | Illinois Center For Neurological And Behavioral Medicine Ltd |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1455 E Golf Rd Ste 207, Des Plaines, Illinois |
| Authorized Official Name and Position | Alan Hirsch (OWNER) |
| Authorized Official Contact | 3126495829 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Center For Neurological And Behavioral Medicine Ltd 350 S Northwest Hwy Ste 302 Park Ridge IL 60068-4262 Ph: (312) 649-5829 | Illinois Center For Neurological And Behavioral Medicine Ltd 1455 E Golf Rd Ste 207 Des Plaines IL 60016-1254 Ph: (312) 649-5829 |
| NPI Number | 1649824459 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Medicare PECOS PAC ID | 5698131670 |
|---|---|
| Medicare Enrollment ID | O20230517001394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649824459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Alan R Hirsch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427387893 PECOS PAC ID: 0244259844 Enrollment ID: I20051114000184 |
| Provider Name | Brianna M Wicinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508415951 PECOS PAC ID: 7214269158 Enrollment ID: I20191028000203 |
| Provider Name | Lenette Baltazar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851028245 PECOS PAC ID: 4587030374 Enrollment ID: I20221019001769 |
| Provider Name | Brittany Anne Orduna Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285344358 PECOS PAC ID: 0345610259 Enrollment ID: I20230110000284 |
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