| Intermission Therapies, Ltd. | |
|
22 Crissey Ave Ste 200 Geneva IL 60134-2351 | |
| (630) 232-7770 | |
| Not Available |
| Full Name | Intermission Therapies, Ltd. |
|---|---|
| Speciality | Social Worker |
| Location | 22 Crissey Ave Ste 200, Geneva, Illinois |
| Authorized Official Name and Position | Marie S Egeland (PRESIDENT) |
| Authorized Official Contact | 6302327770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermission Therapies, Ltd. 22 Crissey Ave Ste 200 Geneva IL 60134-2351 Ph: (630) 232-7770 | Intermission Therapies, Ltd. 22 Crissey Ave Ste 200 Geneva IL 60134-2351 Ph: (630) 232-7770 |
| NPI Number | 1124125752 |
|---|---|
| Provider Enumeration Date | 09/17/2006 |
| Last Update Date | 03/18/2015 |
| Medicare PECOS PAC ID | 2860557592 |
|---|---|
| Medicare Enrollment ID | O20090212000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124125752 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marie S Egeland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578646451 PECOS PAC ID: 5395800023 Enrollment ID: I20091002000577 |
| Provider Name | Randall E Bennett |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1194835702 PECOS PAC ID: 6608227715 Enrollment ID: I20241210002546 |
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