Healthcare Provider Details

I. General information

NPI: 1033397633
Provider Name (Legal Business Name): CMAC VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 02/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 W 22ND ST TOWER FLOOR
OAK BROOK IL
60523-2074
US

IV. Provider business mailing address

1415 W 22ND ST TOWER FLOOR
OAK BROOK IL
60523-2074
US

V. Phone/Fax

Practice location:
  • Phone: 630-571-5555
  • Fax:
Mailing address:
  • Phone: 630-571-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number2007-N1102
License Number StateIL

VIII. Authorized Official

Name: MS. CHERI MCESSY
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 630-571-5555