Healthcare Provider Details

I. General information

NPI: 1851537724
Provider Name (Legal Business Name): EDUCATIONAL CONSULTING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2008
Last Update Date: 12/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 DEER CREEK RD
ROCHESTER IL
62563-9221
US

IV. Provider business mailing address

212 DEER CREEK RD
ROCHESTER IL
62563-9221
US

V. Phone/Fax

Practice location:
  • Phone: 217-498-7781
  • Fax:
Mailing address:
  • Phone: 217-498-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: LYN ANN BECKER
Title or Position: BEHAVIOR ANALYST
Credential:
Phone: 217-498-7781