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General NPI Number Information
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NPI Number | 1275005670
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Entity Type | Organization
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Legal Business Name | PSYCHEALTH SERVICES, INC.
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Dates
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Enumeration Date | 12/23/2018
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 900 JORIE BLVD STE 11
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City | OAK BROOK
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State | IL
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Zip | 60523-2268
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Country | US
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Telephone | 708-990-8221
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Fax | 708-416-8800
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Provider Business Mailing Address
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Address Line | 343 LIONEL RD
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City | RIVERSIDE
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State | IL
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Zip | 60546-2205
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ELVEDINA OWEN
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Credential |
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Telephone | 708-990-6109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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