Organization
ACCESSCOACH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH CELIANO PSY.D (CLINICAL PSYCHOLOGIST/OWNER)
(847) 338-2199
Entity
Organization
Contact information
Practice address
102 MAIN ST STE 200, PARK RIDGE, IL 60068-4028
(847) 338-2199
(847) 292-1088
Mailing address
102 MAIN ST STE 200, PARK RIDGE, IL 60068-4028
(847) 338-2199
(847) 292-1088
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306263173
BCBS IL
IL
Enumeration date
07/27/2017
Last updated
07/21/2022
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