| Psychology Professionals | |
|
9010 Reserve Dr Willow Springs IL 60480-1183 | |
| (708) 268-4159 | |
| (630) 455-0553 |
| Full Name | Psychology Professionals |
|---|---|
| Speciality | Psychologist |
| Location | 9010 Reserve Dr, Willow Springs, Illinois |
| Authorized Official Name and Position | Jenny T Ebeid (PRESIDENT) |
| Authorized Official Contact | 7082684159 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychology Professionals 9010 Reserve Dr Willow Springs IL 60480-1183 Ph: (708) 268-4159 | Psychology Professionals 9010 Reserve Dr Willow Springs IL 60480-1183 Ph: (708) 268-4159 |
| NPI Number | 1245313071 |
|---|---|
| Provider Enumeration Date | 10/23/2006 |
| Last Update Date | 11/18/2016 |
| Medicare PECOS PAC ID | 6709980899 |
|---|---|
| Medicare Enrollment ID | O20070329000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245313071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 071007039 (Illinois) | Primary |
| Provider Name | Jenny Ebeid |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710998679 PECOS PAC ID: 6608870308 Enrollment ID: I20060912000300 |
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