Healthcare Provider Details
I. General information
NPI: 1184642928
Provider Name (Legal Business Name): RLS COMPREHENSIVE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6120 W NORTH AVE SUITE 204
CHICAGO IL
60639-3901
US
IV. Provider business mailing address
PO BOX 346068
CHICAGO IL
60634-6068
US
V. Phone/Fax
- Phone: 773-804-0133
- Fax: 773-804-0240
- Phone: 773-804-0133
- Fax: 773-804-0240
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROMONA
SMITH-BATTLE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 773-804-0133