Provider Demographics
NPI:1639233190
Name:PSYCHCARE ASSOCIATES P.C.
Entity Type:Organization
Organization Name:PSYCHCARE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:P
Authorized Official - Last Name:HATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-851-6100
Mailing Address - Street 1:1700 N FARNSWORTH AVE
Mailing Address - Street 2:SUITE 21
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1523
Mailing Address - Country:US
Mailing Address - Phone:630-851-6100
Mailing Address - Fax:630-851-6154
Practice Address - Street 1:1700 N FARNSWORTH AVE
Practice Address - Street 2:SUITE 21
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1523
Practice Address - Country:US
Practice Address - Phone:630-851-6100
Practice Address - Fax:630-851-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL596400Medicare ID - Type Unspecified