| Psychpromd Llc | |
|
1650 Moon Lake Blvd Hoffman Estates IL 60169-1010 | |
| (312) 599-1948 | |
| Not Available |
| Full Name | Psychpromd Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1650 Moon Lake Blvd, Hoffman Estates, Illinois |
| Authorized Official Name and Position | Shaun Wood (OWNER) |
| Authorized Official Contact | 3125991948 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychpromd Llc 836 S Arlington Heights Rd Ste 342 Elk Grove Village IL 60007-3667 Ph: () - | Psychpromd Llc 1650 Moon Lake Blvd Hoffman Estates IL 60169-1010 Ph: (312) 599-1948 |
| NPI Number | 1346066883 |
|---|---|
| Provider Enumeration Date | 11/30/2024 |
| Last Update Date | 11/30/2024 |
| Certification Date | 11/30/2024 |
| Medicare PECOS PAC ID | 8426587130 |
|---|---|
| Medicare Enrollment ID | O20250124002835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346066883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Purvi S Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881097244 PECOS PAC ID: 6709008667 Enrollment ID: I20141107001187 |
| Provider Name | Shaun P Wood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568461788 PECOS PAC ID: 6709778657 Enrollment ID: I20171116000005 |
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