| Sirona Center, Llc | |
|
2005 Bloomingdale Rd Ste B Glendale Heights IL 60139-2151 | |
| (630) 383-7222 | |
| Not Available |
| Full Name | Sirona Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2005 Bloomingdale Rd Ste B, Glendale Heights, Illinois |
| Authorized Official Name and Position | Kristen M Newberry (OWNER) |
| Authorized Official Contact | 6303837222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sirona Center, Llc 2005 Bloomingdale Rd Ste B Glendale Heights IL 60139-2151 Ph: (630) 383-7222 | Sirona Center, Llc 2005 Bloomingdale Rd Ste B Glendale Heights IL 60139-2151 Ph: (630) 383-7222 |
| NPI Number | 1659830909 |
|---|---|
| Provider Enumeration Date | 03/17/2019 |
| Last Update Date | 06/15/2022 |
| Certification Date | 06/15/2022 |
| Medicare PECOS PAC ID | 6406296086 |
|---|---|
| Medicare Enrollment ID | O20240430001375 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659830909 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristen M Newberry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912152661 PECOS PAC ID: 7214377894 Enrollment ID: I20240430001502 |
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