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NPI Code Detail

MEDICARE: CORNELL INTERVENTIONS, LLC

MEDICARE: CORNELL INTERVENTIONS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory
2261QR0405XSubstance Use Disorder Rehabilitation Clinic/CenterA-8981-0019-AIL

General Provider Information

NPI Number : 1598810764
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORNELL INTERVENTIONS, LLC
Provider Business Mailing Address
First Line : 2840 LIBERTY AVE STE 300
Second Line :
City : PITTSBURGH
State : PA
Zip : 15222-4776
Country : US
Telephone Number : 412-201-4112
Fax Number :
Provider Business Practice Location Address
First Line : 5701 S WOOD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60636-1646
Country : US
Telephone Number : 773-737-4600
Fax Number :
Authorized Official
Title or Position : CONTRACTS DIRECTOR
Name : SHAYNA A RAVER
Credential :
Telephone Number : 724-622-4502
Provider Enumeration Date : 01/25/2007
Last Update Date : 09/09/2025

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5701 S WOOD ST
CHICAGO, IL
60636-1646
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Practice Location Address:
5701 S WOOD ST
CHICAGO, IL
60636-1646
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Practice Fax:
1043365216 — CORNELL INTERVENTIONS, INC.
Practice Location Address:
5701 S WOOD ST
CHICAGO, IL
60636-1646
Practice Phone: 773-737-4600
Practice Fax:
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Practice Location Address:
5829 S ARCHER AVE
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Practice Fax: 773-284-0278

Directions to “CORNELL INTERVENTIONS, LLC ” Practice Location

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