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GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC NPI 1629478599


NPI Information

NPI: 1629478599
Provider Name: GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC

Doing Business As: A RAY OF HOPE: THE GREAT LAKES INSTITUTE OF NEUROLOGY AND PSYCHIATRY

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 14D2108164

Address:
1860 W WINCHESTER RD STE 106
LIBERTYVILLE, IL
ZIP 60048
Phone: (847) 816-6335
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GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC is a neurology psychiatry neurology in Libertyville, IL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC NPI is 1629478599. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As A Ray Of Hope: The Great Lakes Institute Of Neurology And Psychiatry.

The provider's business location address is:

1860 W WINCHESTER RD STE 106
LIBERTYVILLE, IL
ZIP 60048-312
Phone: (847) 816-6335
Fax: (847) 816-6355

The provider's authorized official is Lori A Smith .
The authorized official title is Practice Manager and has the following contact phone number (847) 816-6441.

The CLIA number assigned to this NPI record is 14D2108164 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/28/2014 and was last updated on 3/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurology036133425ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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