Healthcare Provider Details

I. General information

NPI: 1144515156
Provider Name (Legal Business Name): COMPASS HEALTH CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2011
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 REVERE DR SUITE 100
NORTHBROOK IL
60062-1563
US

IV. Provider business mailing address

60 REVERE DR SUITE 100
NORTHBROOK IL
60062-1563
US

V. Phone/Fax

Practice location:
  • Phone: 224-306-1879
  • Fax: 224-306-1878
Mailing address:
  • Phone: 224-306-1879
  • Fax: 224-306-1878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID A SCHREIBER
Title or Position: EXECUTIVE DIRECTOR
Credential: MD
Phone: 224-306-1879