Healthcare Provider Details

I. General information

NPI: 1356097257
Provider Name (Legal Business Name): CENTER FOR COMPREHENSIVE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 KERN ST
NORMAL IL
61761-3368
US

IV. Provider business mailing address

306 W MILL ST
CARBONDALE IL
62901-2727
US

V. Phone/Fax

Practice location:
  • Phone: 618-529-3060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARY PATRICIA RODENBERG-ROBERTS
Title or Position: VP & SR ASST GENERAL COUNSEL
Credential:
Phone: 952-836-2234