Provider Demographics
NPI:1497270995
Name:COMPASS ADDICTION TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:COMPASS ADDICTION TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPALI
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-204-2002
Mailing Address - Street 1:60 REVERE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1574
Mailing Address - Country:US
Mailing Address - Phone:847-204-2002
Mailing Address - Fax:
Practice Address - Street 1:60 REVERE DR STE 201
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1574
Practice Address - Country:US
Practice Address - Phone:847-204-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA-8512-0001-A324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility