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Contact Information

ADVANCE POTENTIAL PSYCHOLOGICAL SERVICES, LLC
2007 W GREENLEAF AVE
CHICAGO, IL60645-3509
 Phone: 773-512-8813
 Fax: 773-743-7696
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for ADVANCE POTENTIAL PSYCHOLOGICAL SERVICES, LLC

NPI Number 1922369941
LBN Legal business name ADVANCE POTENTIAL PSYCHOLOGICAL SERVICES, LLC
Authorized official GLENN SEVIER - (CEO/EXCUTIVE PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/06/2012
Last updated 07/31/2013 - About 13 years ago
Identifiers
IL Medicaid 492722592001
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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