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NPI Code Detail

MEDICARE: PAY IT FORWARD PSYCHIATRY LLC.

MEDICARE: PAY IT FORWARD PSYCHIATRY LLC.
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1396366910
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAY IT FORWARD PSYCHIATRY LLC.
Provider Business Mailing Address
First Line : 8745 W HIGGINS RD STE 110
Second Line :
City : CHICAGO
State : IL
Zip : 60631-2753
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8745 W HIGGINS RD STE 110
Second Line :
City : CHICAGO
State : IL
Zip : 60631-2753
Country : US
Telephone Number : 312-646-0631
Fax Number :
Authorized Official
Title or Position : FOUNDER AND OWNER
Name : MAYA RAMIC
Credential :
Telephone Number : 312-646-0631
Provider Enumeration Date : 05/05/2020
Last Update Date : 05/05/2020

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Directions to “PAY IT FORWARD PSYCHIATRY LLC. ” Practice Location

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