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ASPEN BEHAVIORAL CARE

Clinical Neuropsychologist

Arlington Hts, Illinois

Provider NPI: 1093761439

Organization Information:
Organization Name:  ASPEN BEHAVIORAL CARE
Organization is not Subpart
Authorized Official:  MARK FREDERICK FRAZIER  DIRECTOR  847-2598583

Practice Location:
1655 N ARLINGTON HEIGHTS RD SUITE 102E ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583  Fax: 847-259-8935

Business Mailing Address:
1655 N ARLINGTON HEIGHTS RD SUITE # 102E ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583  Fax: 847-259-8935

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
Y103T00000XBehavioral Health & Social Service Providers
Psychologist

Other Provider Identifiers:

IssuerNumberStateType
AETNA PROVIDER NUMBER7604241IL01
705050IL08
BLUE CROSS BLUE SHIELD21623169IL01
MAGELLAN PROVIDER NUMBER789710000IL01
000073206WI08
CH7909IL08
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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