MEDICARE: ACCESS SERVICES OF NORTHERN ILLINOIS

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
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1790800233
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS SERVICES OF NORTHERN ILLINOIS

Provider Business Mailing Address
First Line	:	7399 FOREST HILLS RD
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-3974
Country	:	US
Telephone Number	:	815-282-8824
Fax Number	:

Provider Business Practice Location Address
First Line	:	7399 FOREST HILLS RD
Second Line	:
City	:	LOVES PARK
State	:	IL
Zip	:	61111-3974
Country	:	US
Telephone Number	:	815-282-8824
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. MATTHEW TOOHEY
Credential	:
Telephone Number	:	815-282-8824

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	07/25/2007

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