Healthcare Provider Details
I. General information
NPI: 1295379972
Provider Name (Legal Business Name): COMPASS HEALTH CENTER OAKBROOK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2019
Last Update Date: 11/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 OAKMONT LN
WESTMONT IL
60559-5551
US
IV. Provider business mailing address
60 REVERE DR STE 100
NORTHBROOK IL
60062-1590
US
V. Phone/Fax
- Phone: 224-306-1879
- Fax: 224-306-1878
- Phone: 224-306-1879
- Fax: 224-306-1878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
A
SCHREIBER
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 224-306-1879