Healthcare Provider Details

I. General information

NPI: 1700273570
Provider Name (Legal Business Name): COMPASS HEALTH CENTER CHICAGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W BRADLEY PL SUITE 100
CHICAGO IL
60618-4702
US

IV. Provider business mailing address

60 REVERE DR SUITE 100
NORTHBROOK IL
60062-1563
US

V. Phone/Fax

Practice location:
  • Phone: 224-306-1879
  • Fax: 224-306-1878
Mailing address:
  • Phone: 224-306-1879
  • Fax: 224-306-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID SCHREIBER
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 224-306-1879