Provider Demographics
NPI:1275170318
Name:COZZI CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:COZZI CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:COZZI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-823-9205
Mailing Address - Street 1:904 CASE ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2895
Mailing Address - Country:US
Mailing Address - Phone:815-823-9205
Mailing Address - Fax:
Practice Address - Street 1:101 1/2 E FRONT ST STE 104
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-5334
Practice Address - Country:US
Practice Address - Phone:630-216-4038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty