Healthcare Provider Details

I. General information

NPI: 1033378385
Provider Name (Legal Business Name): PROMISES OF RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 MADISON ST STE 302
JOLIET IL
60435-6576
US

IV. Provider business mailing address

330 MADISON ST STE 302
JOLIET IL
60435-6576
US

V. Phone/Fax

Practice location:
  • Phone: 815-725-7036
  • Fax: 815-744-3768
Mailing address:
  • Phone: 815-725-7036
  • Fax: 815-744-3768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberA-4389-0001-A
License Number StateIL

VIII. Authorized Official

Name: DR. ABHIN SINGLA
Title or Position: EXECUTIVE/MEDICAL DIRECTOR
Credential: M.D.
Phone: 815-744-0029