Provider Demographics
NPI:1417217332
Name:COMMUNITY INTEGRATIVE HEALTH NETWORK
Entity Type:Organization
Organization Name:COMMUNITY INTEGRATIVE HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EARNEST
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-360-2446
Mailing Address - Street 1:3330 W 177TH ST
Mailing Address - Street 2:SUITE 1-F
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2184
Mailing Address - Country:US
Mailing Address - Phone:630-360-2446
Mailing Address - Fax:708-799-1889
Practice Address - Street 1:3330 W 177TH ST
Practice Address - Street 2:SUITE 1-F
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2184
Practice Address - Country:US
Practice Address - Phone:630-360-2446
Practice Address - Fax:708-799-1889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health