Provider Demographics
NPI:1518036425
Name:BEHAVIORAL SERVICES CENTER, P.C.
Entity Type:Organization
Organization Name:BEHAVIORAL SERVICES CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISYANOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-673-8577
Mailing Address - Street 1:8707 SKOKIE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2269
Mailing Address - Country:US
Mailing Address - Phone:847-673-8577
Mailing Address - Fax:847-568-0411
Practice Address - Street 1:8707 SKOKIE BLVD STE 207
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-673-8577
Practice Address - Fax:847-568-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-1587-0003-A251S00000X
ILA-1587-003-A261QM2800X
261QM2800X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder