| Wodka & Associates Ltd | |
|
1119 Deerpass Rd Marengo IL 60152-8065 | |
| (847) 308-3266 | |
| Not Available |
| Full Name | Wodka & Associates Ltd |
|---|---|
| Speciality | Psychologist |
| Location | 1119 Deerpass Rd, Marengo, Illinois |
| Authorized Official Name and Position | Steven Smith (MANAGER) |
| Authorized Official Contact | 5022449859 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wodka & Associates Ltd 1119 Deerpass Rd Marengo IL 60152-8065 Ph: (847) 308-3266 | Wodka & Associates Ltd 1119 Deerpass Rd Marengo IL 60152-8065 Ph: (847) 308-3266 |
| NPI Number | 1316533953 |
|---|---|
| Provider Enumeration Date | 12/17/2020 |
| Last Update Date | 12/17/2020 |
| Certification Date | 12/17/2020 |
| Medicare PECOS PAC ID | 1456764422 |
|---|---|
| Medicare Enrollment ID | O20210112001438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316533953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Steven L Wodka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225099872 PECOS PAC ID: 1951358654 Enrollment ID: I20050405000771 |
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