Provider Demographics
NPI:1922339183
Name:ALPHA OMEGA AMERICA INC.
Entity Type:Organization
Organization Name:ALPHA OMEGA AMERICA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FLORENTINE
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:WILK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-931-9455
Mailing Address - Street 1:PO BOX 747
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-0747
Mailing Address - Country:US
Mailing Address - Phone:847-931-9455
Mailing Address - Fax:
Practice Address - Street 1:75 MARKET ST
Practice Address - Street 2:STE. 14
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-5093
Practice Address - Country:US
Practice Address - Phone:847-931-9455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty