| Organization Name: | ILLINOIS ASSOCIATES PSYCHIATRY P C |
| NPI Number: | 1023108875 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY ANNE STEVENS (OPERATIONS MANAGER) |
| Mailing Address: | 103a South Pointe Drive Edwardsville |
| State: | IL US |
| Postal Code: | 620253780 |
| Phone Number: | 6186562000 |
| Fax Number: | 6186561169 |
| NPI Enumeration Date: | 10/13/2006 |
| NPI Last Update Date: | 12/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 060006403 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |