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:
3233 N ARLINGTON HEIGHTS RD STE 100 ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583 Fax: 847-259-8935
Business Mailing Address:
3233 N ARLINGTON HEIGHTS RD STE 100 ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583 Fax: 847-259-8935
Entity Type: Organization
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Organization is not Subpart
Authorized Official: MARK FREDERICK FRAZIER DIRECTOR 847-2598583
Practice Location:
3233 N ARLINGTON HEIGHTS RD STE 100 ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583 Fax: 847-259-8935
Business Mailing Address:
3233 N ARLINGTON HEIGHTS RD STE 100 ARLINGTON HTS, IL 60004 US
Tel: 847-259-8583 Fax: 847-259-8935
Entity Type: Organization
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | ||
Y | 103T00000X | Behavioral Health & Social Service Providers Psychologist |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
AETNA PROVIDER NUMBER | 7604241 | IL | 01 |
MAGELLAN PROVIDER NUMBER | 789710000 | IL | 01 |
BLUE CROSS BLUE SHIELD | 21623169 | IL | 01 |
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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