| 670-672 Chaney Ct | |
|
670 Chaney Ct # 672 Cresthill IL 60403 | |
| (815) 741-7045 | |
| Not Available |
| Full Name | 670-672 Chaney Ct |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 670 Chaney Ct # 672, Cresthill, Illinois |
| Authorized Official Name and Position | Benjamin Stortz (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 8157417042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 670-672 Chaney Ct 670 Chaney Ct # 672 Cresthill IL 60403-2494 Ph: (815) 741-7045 | 670-672 Chaney Ct 670 Chaney Ct # 672 Cresthill IL 60403 Ph: (815) 741-7045 |
| NPI Number | 1912175159 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912175159 | NPI | - | NPPES |
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