Healthcare Provider Details

I. General information

NPI: 1760647226
Provider Name (Legal Business Name): JOLIET CENTER FOR CLINICAL RESEARCH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N HAMMES AVE STE 205
JOLIET IL
60435-8139
US

IV. Provider business mailing address

210 N HAMMES AVE STE 205
JOLIET IL
60435-8139
US

V. Phone/Fax

Practice location:
  • Phone: 815-729-7790
  • Fax: 815-725-8144
Mailing address:
  • Phone: 815-729-7790
  • Fax: 815-725-8144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. COSME O LOZANO JR.
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 630-408-1099