Organization
ALLIANCE CLINICAL ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH P PHILLIPS MD (PRESIDENT)
(630) 653-2300
Entity
Organization
Contact information
Practice address
7 BLANCHARD CIR, SUITE 201, WHEATON, IL 60189-2039
(630) 653-2300
(630) 653-2895
Mailing address
7 BLANCHARD CIR, SUITE 201, WHEATON, IL 60189-2039
(630) 653-2300
(630) 653-2895
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215643
BLUE CROSS
IL
Enumeration date
03/16/2006
Last updated
08/23/2010
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