Provider Demographics
NPI:1356839542
Name:NANCEY E. PECEN, M.D. ,S.C.
Entity Type:Organization
Organization Name:NANCEY E. PECEN, M.D. ,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RYNIEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-473-3970
Mailing Address - Street 1:4580 WEAVER PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3864
Mailing Address - Country:US
Mailing Address - Phone:630-473-3970
Mailing Address - Fax:
Practice Address - Street 1:4580 WEAVER PKWY STE 204
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3864
Practice Address - Country:US
Practice Address - Phone:630-473-3970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.056703261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)