| Spoke Therapy | |
|
636 Church St Ste 515 Evanston IL 60201-4581 | |
| (847) 904-1220 | |
| Not Available |
| Full Name | Spoke Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 636 Church St Ste 515, Evanston, Illinois |
| Authorized Official Name and Position | Renee B Wright (PRESIDENT) |
| Authorized Official Contact | 8479041220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Spoke Therapy 2830 Harrison St Evanston IL 60201-1218 Ph: (847) 207-1065 | Spoke Therapy 636 Church St Ste 515 Evanston IL 60201-4581 Ph: (847) 904-1220 |
| NPI Number | 1609000462 |
|---|---|
| Provider Enumeration Date | 05/08/2009 |
| Last Update Date | 01/19/2024 |
| Certification Date | 01/19/2024 |
| Medicare PECOS PAC ID | 7517016066 |
|---|---|
| Medicare Enrollment ID | O20090513000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609000462 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149-007117 (Illinois) | Primary |
| Provider Name | Renee B Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699843755 PECOS PAC ID: 1951293463 Enrollment ID: I20040329000927 |
| Provider Name | Amanda J Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467093286 PECOS PAC ID: 6103250170 Enrollment ID: I20191227001358 |
| Provider Name | Alexandra Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1083295281 PECOS PAC ID: 0244649762 Enrollment ID: I20210512001911 |
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