Healthcare Provider Details

I. General information

NPI: 1780223529
Provider Name (Legal Business Name): OASIS COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 06/23/2020
Certification Date: 06/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 KENSINGTON RD UNIT 4531
OAK BROOK IL
60522-7136
US

IV. Provider business mailing address

7956 BIRCH DR
HAMMOND IN
46324-3329
US

V. Phone/Fax

Practice location:
  • Phone: 630-324-4996
  • Fax: 219-844-0195
Mailing address:
  • Phone: 219-781-1113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY S DILLON
Title or Position: OWNER/MANAGER
Credential: LCPC
Phone: 219-781-1113