| Oak Brook Counseling & Wellness Ltd | |
|
1010 Jorie Blvd Oak Brook IL 60523-2215 | |
| (630) 710-5729 | |
| Not Available |
| Full Name | Oak Brook Counseling & Wellness Ltd |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1010 Jorie Blvd, Oak Brook, Illinois |
| Authorized Official Name and Position | Sabrina R. Gosmire (LICENSED CLINCAL PROFESSIONAL COUNS) |
| Authorized Official Contact | 6307105729 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Brook Counseling & Wellness Ltd 1413 S Addison Ave Lombard IL 60148-4118 Ph: (630) 710-5729 | Oak Brook Counseling & Wellness Ltd 1010 Jorie Blvd Oak Brook IL 60523-2215 Ph: (630) 710-5729 |
| NPI Number | 1568721447 |
|---|---|
| Provider Enumeration Date | 05/11/2012 |
| Last Update Date | 05/11/2012 |
| Medicare PECOS PAC ID | 6507194750 |
|---|---|
| Medicare Enrollment ID | O20190826002177 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568721447 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 180005477 (Illinois) | Primary |
| Provider Name | Ava L Blalark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831337807 PECOS PAC ID: 4284928722 Enrollment ID: I20160808000079 |
| Provider Name | Candida Jacoby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164939872 PECOS PAC ID: 8022352004 Enrollment ID: I20181203000049 |
| Provider Name | Emily Claire Papaeliou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407496078 PECOS PAC ID: 9335556026 Enrollment ID: I20210324002844 |
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