1316275779 NPI number — COMMUNITY HEALTH SERVICES LLC

Table of content: (NPI 1316275779)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316275779 NPI number — COMMUNITY HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY HEALTH SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316275779
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17843 TORRENCE AVE
Provider Second Line Business Mailing Address:
SUITE 2R
Provider Business Mailing Address City Name:
LANSING
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60438-1835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-983-5137
Provider Business Mailing Address Fax Number:
708-394-0241

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17843 TORRENCE AVE
Provider Second Line Business Practice Location Address:
SUITE 2R
Provider Business Practice Location Address City Name:
LANSING
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60438-1835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-983-5137
Provider Business Practice Location Address Fax Number:
708-394-0241
Provider Enumeration Date:
11/24/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADEOYE
Authorized Official First Name:
ADEOLU
Authorized Official Middle Name:
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
312-608-4951

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)