Organization
GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY SC
Active
Other names
A Ray of Hope: The Great Lakes Institute of Neurology and Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
LORI A SMITH (PRACTICE MANAGER)
(847) 816-6441
Entity
Organization
Contact information
Practice address
1860 W WINCHESTER RD STE 106, LIBERTYVILLE, IL 60048-5312
(847) 816-6335
(847) 816-6355
Mailing address
1860 W WINCHESTER RD STE 106, LIBERTYVILLE, IL 60048-5312
(847) 816-6335
(847) 816-6355
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
2084N0400X
Neurology Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
08/28/2014
Last updated
01/17/2025
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