Healthcare Provider Details

I. General information

NPI: 1851700256
Provider Name (Legal Business Name): COMPASS HEALTHCARE CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 BARRINGTON RD
HOFFMAN ESTATES IL
60169-1019
US

IV. Provider business mailing address

1690 DUNLAWTON AVE SUITE 130
PORT ORANGE FL
32127-8979
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-6932
  • Fax:
Mailing address:
  • Phone: 847-836-7015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: KENDALL LUTZ
Title or Position: PRACTICE MANAGER
Credential:
Phone: 847-836-7015