Provider Demographics
NPI:1477515393
Name:COMPREHENSIVE EMERGENCY SOLUTIONS SC
Entity Type:Organization
Organization Name:COMPREHENSIVE EMERGENCY SOLUTIONS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:SOWARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:877-485-4474
Mailing Address - Street 1:DEPT 960347
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0347
Mailing Address - Country:US
Mailing Address - Phone:877-485-4474
Mailing Address - Fax:
Practice Address - Street 1:221 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-4307
Practice Address - Country:US
Practice Address - Phone:309-672-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL7232106OtherBCBS
ILDC5362OtherRAILROAD MEDICARE
ILDC5362OtherRAILROAD MEDICARE
IL210426Medicare ID - Type Unspecified