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General NPI Number Information
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NPI Number | 1760647226
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Entity Type | Organization
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Legal Business Name | JOLIET CENTER FOR CLINICAL RESEARCH, INC
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Dates
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Enumeration Date | 07/24/2008
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 210 N HAMMES AVE STE 205
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City | JOLIET
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State | IL
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Zip | 60435-8139
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Country | US
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Telephone | 815-729-7790
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Fax | 815-725-8144
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Provider Business Mailing Address
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Address Line | 210 N HAMMES AVE STE 205
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City | JOLIET
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State | IL
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Zip | 60435-8139
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Country | US
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Telephone | 815-729-7790
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Fax | 815-725-8144
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. COSME O LOZANO JR.
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Credential | M.D.
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Telephone | 630-408-1099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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