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NPI Code Detail

MEDICARE: ANDERSON CLINICAL SERVICES CORP

MEDICARE: ANDERSON CLINICAL SERVICES CORP
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1801353107
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANDERSON CLINICAL SERVICES CORP
Provider Business Mailing Address
First Line : 16057 DOBSON AVE
Second Line :
City : SOUTH HOLLAND
State : IL
Zip : 60473-1738
Country : US
Telephone Number : 708-638-9648
Fax Number :
Provider Business Practice Location Address
First Line : 16057 DOBSON AVE
Second Line :
City : SOUTH HOLLAND
State : IL
Zip : 60473-1738
Country : US
Telephone Number : 708-295-3502
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BETSY COLVIN
Credential : LCSW
Telephone Number : 708-295-3502
Provider Enumeration Date : 02/23/2019
Last Update Date : 04/30/2026

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