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General NPI Number Information
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NPI Number | 1629345285
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE SERVICES OF ILLINOIS INCORPORATED
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Dates
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Enumeration Date | 11/28/2011
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 2605 LINCOLN HWY 114
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1846
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Country | US
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Telephone | 708-503-1274
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Fax | 708-503-1000
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Provider Business Mailing Address
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Address Line | 2605 LINCOLN HWY 114
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1846
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Country | US
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Telephone | 708-503-1274
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Fax | 708-503-1000
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Authorized Official
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Title or Position | PRESIDENT/CHIEF EXECUTIVE OFFICER
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Name | MS. MIA F COLLINS
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Credential | MS, MSW, LCSW, CADC
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Telephone | 708-289-2659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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