Provider Demographics
NPI:1104004266
Name:CIRCLE OF SUPPORT, INC.
Entity Type:Organization
Organization Name:CIRCLE OF SUPPORT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:847-895-8523
Mailing Address - Street 1:105 S ROSELLE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-1661
Mailing Address - Country:US
Mailing Address - Phone:847-895-8523
Mailing Address - Fax:847-895-9523
Practice Address - Street 1:105 S ROSELLE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-1661
Practice Address - Country:US
Practice Address - Phone:847-895-8523
Practice Address - Fax:847-895-9523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health