| Chicago Integrative Center For Psychology Llc | |
|
900 North Shore Dr Ste 120 Lake Bluff IL 60044-2225 | |
| (847) 615-1698 | |
| (847) 615-1697 |
| Full Name | Chicago Integrative Center For Psychology Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 900 North Shore Dr Ste 120, Lake Bluff, Illinois |
| Authorized Official Name and Position | Erin Bright (COO) |
| Authorized Official Contact | 8476151698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Integrative Center For Psychology Llc 900 North Shore Dr Ste 120 Lake Bluff IL 60044-2225 Ph: (847) 615-1698 | Chicago Integrative Center For Psychology Llc 900 North Shore Dr Ste 120 Lake Bluff IL 60044-2225 Ph: (847) 615-1698 |
| NPI Number | 1649785486 |
|---|---|
| Provider Enumeration Date | 12/01/2017 |
| Last Update Date | 11/15/2021 |
| Certification Date | 11/15/2021 |
| Medicare PECOS PAC ID | 6800288754 |
|---|---|
| Medicare Enrollment ID | O20220126002063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649785486 | NPI | - | NPPES |
| 1083632384 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Mark Shukhman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225087752 PECOS PAC ID: 3274599592 Enrollment ID: I20041208000126 |
| Provider Name | Amera Manzoor Rahman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760502306 PECOS PAC ID: 7719046192 Enrollment ID: I20081030000742 |
| Provider Name | Bradley M Pechter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093922346 PECOS PAC ID: 4284851106 Enrollment ID: I20140815001756 |
| Provider Name | John S Hurd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194123703 PECOS PAC ID: 0345563870 Enrollment ID: I20150108000424 |
| Provider Name | Danielle Baran |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962805275 PECOS PAC ID: 7719290873 Enrollment ID: I20150717001540 |
| Provider Name | Patricia Marchman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821528555 PECOS PAC ID: 5698048791 Enrollment ID: I20170912003066 |
| Provider Name | Michael Ficaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346903291 PECOS PAC ID: 0547648974 Enrollment ID: I20220525002800 |
| Provider Name | Dina Froustis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487224747 PECOS PAC ID: 3072983634 Enrollment ID: I20230309001088 |
| Provider Name | Kelsey Stender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952913014 PECOS PAC ID: 0547629966 Enrollment ID: I20230703002326 |
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