MEDICARE: SUCCESS TMS PROFESSIONAL SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1457997496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUCCESS TMS PROFESSIONAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 950510
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-0510
Country	:	US
Telephone Number	:	855-711-4867
Fax Number	:	641-800-3145

Provider Business Practice Location Address
First Line	:	1500 WAUKEGAN RD STE 213
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60025-2165
Country	:	US
Telephone Number	:	855-940-4867
Fax Number	:	855-721-4867

Authorized Official
Title or Position	:	DIRECTOR OF MANAGED CARE
Name	:	PATRICIA WILLET
Credential	:
Telephone Number	:	855-711-4867

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	05/26/2026

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