| Life Stages Therapeutic Services Llc | |
|
163 E Jackson St Elmhurst IL 60126 | |
| (773) 315-2810 | |
| Not Available |
| Full Name | Life Stages Therapeutic Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 163 E Jackson St, Elmhurst, Illinois |
| Authorized Official Name and Position | Adam Apostolovich (OWNER) |
| Authorized Official Contact | 7733152810 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Stages Therapeutic Services Llc 163 E Jackson St Elmhurst IL 60126-5145 Ph: (773) 315-2810 | Life Stages Therapeutic Services Llc 163 E Jackson St Elmhurst IL 60126 Ph: (773) 315-2810 |
| NPI Number | 1831676683 |
|---|---|
| Provider Enumeration Date | 07/24/2018 |
| Last Update Date | 08/17/2018 |
| Medicare PECOS PAC ID | 2961751359 |
|---|---|
| Medicare Enrollment ID | O20180817001818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831676683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.018975 (Illinois) | Primary |
| Provider Name | Adam Apostolovich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215473285 PECOS PAC ID: 0547542961 Enrollment ID: I20170119002627 |
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