MEDICARE: PIREC PSYCHIATRIC SERVICES 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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1598580805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIREC PSYCHIATRIC SERVICES LLC

Provider Business Mailing Address
First Line	:	4250 N MARINE DR STE 230
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4250 N MARINE DR STE 230
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-6209
Country	:	US
Telephone Number	:	773-692-1556
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VESNA PIREC
Credential	:	MD, PHD
Telephone Number	:	773-692-1556

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/21/2024

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