Provider Demographics
NPI:1720225725
Name:PEER SERVICES, INC.
Entity Type:Organization
Organization Name:PEER SERVICES, INC.
Other - Org Name:GLENVIEW OFFICE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-492-1778
Mailing Address - Street 1:3633 W LAKE AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-5805
Mailing Address - Country:US
Mailing Address - Phone:847-657-7337
Mailing Address - Fax:847-657-7331
Practice Address - Street 1:3633 W LAKE AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-5805
Practice Address - Country:US
Practice Address - Phone:847-657-7337
Practice Address - Fax:847-657-7331
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEER SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-0502-0002-A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILA-0502-0002-AOtherSTATE OF ILLINOIS DHS LICENSE