Provider Demographics
NPI:1205816345
Name:CORNERSTONE SERVICES INC
Entity Type:Organization
Organization Name:CORNERSTONE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:STORTZ
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:815-741-7042
Mailing Address - Street 1:777 JOYCE RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60436-1876
Mailing Address - Country:US
Mailing Address - Phone:815-741-7042
Mailing Address - Fax:815-741-6740
Practice Address - Street 1:777 JOYCE RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60436-1876
Practice Address - Country:US
Practice Address - Phone:815-741-7042
Practice Address - Fax:815-741-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-17
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CG7573OtherPALMETTO GBA
IL9919750OtherBLUE CROSS
CG7573OtherPALMETTO GBA
IL=========001Medicaid