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General NPI Number Information
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NPI Number | 1346661139
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF NEUROBEHAVIOR SERVICES SC
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Dates
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Enumeration Date | 12/20/2013
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 14315 108TH AVE SUITE 215
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City | ORLAND PARK
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State | IL
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Zip | 60467-5700
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Country | US
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Telephone | 708-586-9751
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Fax |
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Provider Business Mailing Address
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Address Line | 14315 108TH AVE SUITE 215
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City | ORLAND PARK
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State | IL
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Zip | 60467-5700
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Country | US
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Telephone | 708-586-9751
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | DR. EVALDAS RADZEVICIUS
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Credential | MD
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Telephone | 312-860-7017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036126035
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License Number State | IL
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