MEDICARE: PROFESSIONAL ACCOUNTS RECEIVABLE MANAGEMENT TEAM

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	09932047	OTHER	IL	BC

General Provider Information

NPI Number	:	1881760353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL ACCOUNTS RECEIVABLE MANAGEMENT TEAM

Provider Business Mailing Address
First Line	:	1820 RIDGE RD
Second Line	:	SUITE 104
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-1760
Country	:	US
Telephone Number	:	708-647-7550
Fax Number	:	708-647-7564

Provider Business Practice Location Address
First Line	:	1820 RIDGE RD
Second Line	:	SUITE 104
City	:	HOMEWOOD
State	:	IL
Zip	:	60430-1760
Country	:	US
Telephone Number	:	708-647-7550
Fax Number	:	708-647-7564

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SABRINA M MOORE
Credential	:
Telephone Number	:	708-647-7550

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	03/17/2008

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