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SUMMIT CLINICAL SERVICES PC NPI 1518082502


NPI Information

NPI: 1518082502
Provider Name: SUMMIT CLINICAL SERVICES PC
Classification: Counselor - 101Y00000X
Entity Type: Organization
Address:
1761 S NAPERVILLE RD STE 200
WHEATON, IL
ZIP 60189
Phone: (630) 260-0606
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SUMMIT CLINICAL SERVICES PC is a counselor in Wheaton, IL. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. SUMMIT CLINICAL SERVICES PC NPI is 1518082502. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1761 S NAPERVILLE RD STE 200
WHEATON, IL
ZIP 60189-846
Phone: (630) 260-0606
Fax: (630) 260-1049

The provider's authorized official is Daniel R Wyma .
The authorized official title is Owner and has the following contact phone number (630) 260-0606.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 3/14/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101Y00000XCounselor149014503ILLINOISNo
22084P0800XPsychiatry & NeurologyPsychiatry036124166ILLINOISNo
32084P0800XPsychiatry & NeurologyPsychiatry036128880ILLINOISNo
4101Y00000XCounselor180004554ILLINOISNo
5101YP2500XCounselorProfessional180002875ILLINOISNo
6101YP2500XCounselorProfessional180004799ILLINOISNo
7103TC0700XPsychologistClinical071003388ILLINOISNo
8103TC0700XPsychologistClinical071005180ILLINOISNo
9104100000XSocial Worker149000008ILLINOISNo
101041C0700XSocial WorkerClinical149006444ILLINOISNo
111041C0700XSocial WorkerClinical149003718ILLINOISNo
12106H00000XMarriage & Family Therapist166000545ILLINOISNo
132084P0800XPsychiatry & NeurologyPsychiatry036063557ILLINOISNo
142084P0800XPsychiatry & NeurologyPsychiatry036089544ILLINOISNo
15101Y00000XCounselor071007924ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10002220764OTHERILLINOISILLINOIS BLUE CROSS ID #
2342160MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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