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General NPI Number Information
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NPI Number | 1245105238
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH AND IMMUNIZATION SERVICES, LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 111 W WASHINGTON ST STE 1440
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City | CHICAGO
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State | IL
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Zip | 60602-3966
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Country | US
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Telephone | 844-358-3733
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Fax |
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Provider Business Mailing Address
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Address Line | 4343 E OUTLIER BLVD STE 100W
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City | PHOENIX
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State | AZ
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Zip | 85008-6540
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AR DIRECTOR
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Name | MICHAEL C HAYMORE
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Credential |
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Telephone | 405-645-6002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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