| Ican Community Services Inc. Nfp | |
|
15475 S Park Ave Ste 109 South Holland IL 60473-1377 | |
| (708) 596-5680 | |
| (708) 596-5687 |
| Full Name | Ican Community Services Inc. Nfp |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 15475 S Park Ave Ste 109, South Holland, Illinois |
| Authorized Official Name and Position | Anthony Olujimi (CEO) |
| Authorized Official Contact | 7085965680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ican Community Services Inc. Nfp 15475 S Park Ave Ste 109 South Holland IL 60473-1377 Ph: (708) 596-5680 | Ican Community Services Inc. Nfp 15475 S Park Ave Ste 109 South Holland IL 60473-1377 Ph: (708) 596-5680 |
| NPI Number | 1326544735 |
|---|---|
| Provider Enumeration Date | 04/04/2018 |
| Last Update Date | 04/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326544735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 17009 (Illinois) | Primary |
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