| Kris Cisco | |
|
1520 N Rock Run Dr Suite 30a Crest Hill IL 60435-3153 | |
| (815) 741-3009 | |
| (815) 741-8322 |
| Full Name | Kris Cisco |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1520 N Rock Run Dr, Crest Hill, Illinois |
| Authorized Official Name and Position | Kris Cisco (OWNER) |
| Authorized Official Contact | 8157413009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kris Cisco 1520 N Rock Run Dr Suite 30a Crest Hill IL 60435-3153 Ph: (815) 741-3009 | Kris Cisco 1520 N Rock Run Dr Suite 30a Crest Hill IL 60435-3153 Ph: (815) 741-3009 |
| NPI Number | 1912917725 |
|---|---|
| Provider Enumeration Date | 08/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912917725 | NPI | - | NPPES |
| 09932284 | Other | IL | BCBS OF IL PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (Illinois) | Primary |
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