| Kjp Alliance Llc | |
|
16595 W Easton Ave Ste 1 Lincolnshire IL 60069-2744 | |
| (847) 242-1669 | |
| (847) 242-1669 |
| Full Name | Kjp Alliance Llc |
|---|---|
| Speciality | Psychologist |
| Location | 16595 W Easton Ave Ste 1, Lincolnshire, Illinois |
| Authorized Official Name and Position | David Schaefer (DIRECTOR) |
| Authorized Official Contact | 7733506560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kjp Alliance Llc 136 Park Dr Port Barrington IL 60010-1031 Ph: (773) 350-6560 | Kjp Alliance Llc 16595 W Easton Ave Ste 1 Lincolnshire IL 60069-2744 Ph: (847) 242-1669 |
| NPI Number | 1417556283 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 10/22/2020 |
| Certification Date | 10/20/2020 |
| Medicare PECOS PAC ID | 1456872829 |
|---|---|
| Medicare Enrollment ID | O20250303001392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417556283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Lynn Rodgers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1780632448 PECOS PAC ID: 7719425958 Enrollment ID: I20240819002424 |
| Provider Name | David Joseph Schaefer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740573021 PECOS PAC ID: 3678907755 Enrollment ID: I20250303001447 |
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