Healthcare Provider Details

I. General information

NPI: 1326913757
Provider Name (Legal Business Name): COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CENTER DR STE 107
VERNON HILLS IL
60061-1525
US

IV. Provider business mailing address

4343 E OUTLIER BLVD STE 100W
PHOENIX AZ
85008-6540
US

V. Phone/Fax

Practice location:
  • Phone: 844-358-3733
  • Fax:
Mailing address:
  • Phone: 844-358-3733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL C HAYMORE
Title or Position: AR DIRECTOR
Credential:
Phone: 405-645-6002