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Contact Information

MID-AMERICA PSYCHIATRIC CONSULTANTS, LLC
2120 MADISON AVE
SUITE 404
GRANITE CITY, IL62040
 Phone: 618-876-7515
 Fax: 618-876-7596
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for MID-AMERICA PSYCHIATRIC CONSULTANTS, LLC

NPI Number 1750451993
LBN Legal business name MID-AMERICA PSYCHIATRIC CONSULTANTS, LLC
Authorized official ASIF HABIB - (CO OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/08/2006
Last updated 04/20/2016 - About 10 years ago
Identifiers
MO Medicaid 505200402002
IL Other 0006030018 BLUE CROSS BLUE SHIELD
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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