Healthcare Provider Details

I. General information

NPI: 1720330343
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 10/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 BERKSHIRE LN
DES PLAINES IL
60016-7541
US

IV. Provider business mailing address

PO BOX 2825
CARBONDALE IL
62902-2825
US

V. Phone/Fax

Practice location:
  • Phone: 847-204-1310
  • Fax:
Mailing address:
  • Phone: 618-529-3060
  • Fax: 618-529-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER JOHN WILLIAMSON
Title or Position: VICE PRESIDENT OPERATIONS
Credential:
Phone: 618-529-3060