| Thomson Memory Center Llc | |
|
1451 Merchant Dr Algonquin IL 60102-5917 | |
| (847) 469-7537 | |
| (847) 469-7540 |
| Full Name | Thomson Memory Center Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1451 Merchant Dr, Algonquin, Illinois |
| Authorized Official Name and Position | Christina Joy Blodgett (OWNER) |
| Authorized Official Contact | 8474697537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomson Memory Center Llc 1451 Merchant Dr Algonquin IL 60102-5917 Ph: (847) 469-7537 | Thomson Memory Center Llc 1451 Merchant Dr Algonquin IL 60102-5917 Ph: (847) 469-7537 |
| NPI Number | 1124296082 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 06/04/2020 |
| Certification Date | 06/04/2020 |
| Medicare PECOS PAC ID | 7113098278 |
|---|---|
| Medicare Enrollment ID | O20080617000373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124296082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Christina J Blodgett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003092008 PECOS PAC ID: 4688745748 Enrollment ID: I20080617000350 |
| Provider Name | Holly M Hagen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932537545 PECOS PAC ID: 6204062292 Enrollment ID: I20131121001225 |
| Provider Name | Patricia Ann Lingo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619374733 PECOS PAC ID: 0345532461 Enrollment ID: I20160711002383 |
| Provider Name | Arina Polevoy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245774157 PECOS PAC ID: 7315220266 Enrollment ID: I20170220001640 |
| Provider Name | Amanda Schnibben |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316450281 PECOS PAC ID: 7113284852 Enrollment ID: I20171205001138 |
| Provider Name | Calsey Elizabeth Fasching |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194232975 PECOS PAC ID: 5496015067 Enrollment ID: I20180131001245 |
| Provider Name | Amina Homeidan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386103570 PECOS PAC ID: 4284975046 Enrollment ID: I20190405000077 |
| Provider Name | Livia Bir |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033794318 PECOS PAC ID: 3678978509 Enrollment ID: I20210816002865 |
| Provider Name | Nickolas Edward Armstrong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205443975 PECOS PAC ID: 0749669828 Enrollment ID: I20220621000052 |
| Provider Name | Stephanie Ross Potts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144873159 PECOS PAC ID: 1254661432 Enrollment ID: I20230530002046 |
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