Provider Demographics
NPI:1699050435
Name:NEUROCARE AND FAMILY SERVICES P.C.
Entity type:Organization
Organization Name:NEUROCARE AND FAMILY SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:REINKE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-260-8780
Mailing Address - Street 1:1749 S NAPERVILLE RD STE 106
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5892
Mailing Address - Country:US
Mailing Address - Phone:630-260-8780
Mailing Address - Fax:630-938-4697
Practice Address - Street 1:1749 S NAPERVILLE RD STE 106
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-5892
Practice Address - Country:US
Practice Address - Phone:630-260-8780
Practice Address - Fax:630-938-4697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007671103G00000X, 103TA0400X, 103TA0700X, 103TC0700X, 103TC1900X, 103TC2200X, 103TR0400X, 106H00000X
103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & AgingGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000000Other000000