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General NPI Number Information
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NPI Number | 1326164922
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Entity Type | Organization
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Legal Business Name | SUBURBAN ACCESS, INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 925 W. 175TH STREET 3RD FLOOR
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City | HOMEWOOD
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State | IL
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Zip | 60430
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Country | US
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Telephone | 708-799-6123
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Fax | 708-799-2314
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Provider Business Mailing Address
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Address Line | 925 W. 175TH STREET 3RD FLOOR
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City | HOMEWOOD
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State | IL
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Zip | 60430
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Country | US
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Telephone | 708-799-6123
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Fax | 708-799-2314
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | EUGENIA M CUTLER
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Credential |
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Telephone | 708-799-6123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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