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General NPI Number Information
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NPI Number | 1376127191
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Entity Type | Organization
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Legal Business Name | COMPASS HEALTH VIRTUAL CENTER PLLC
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Dates
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Enumeration Date | 05/07/2021
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 60 REVERE DR STE 100
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City | NORTHBROOK
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State | IL
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Zip | 60062-1590
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Country | US
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Telephone | 773-266-6681
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Fax |
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Provider Business Mailing Address
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Address Line | 60 REVERE DR STE 100
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City | NORTHBROOK
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State | IL
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Zip | 60062-1590
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Country | US
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Telephone | 773-266-6681
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DAVID SCHREIBER
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Credential |
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Telephone | 224-306-1879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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