Healthcare Provider Details

I. General information

NPI: 1295903110
Provider Name (Legal Business Name): PILLARS COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2008
Last Update Date: 12/13/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6415 STANLEY AVE
BERWYN IL
60402-3130
US

IV. Provider business mailing address

333 N LA GRANGE RD
LA GRANGE IL
60526-5646
US

V. Phone/Fax

Practice location:
  • Phone: 708-788-0511
  • Fax:
Mailing address:
  • Phone: 708-745-5277
  • Fax: 708-698-5090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANGELA SIRNA CURRAN
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 708-579-4781