Provider Demographics
NPI:1518322817
Name:CHICAGOLAND'S MEDICAL SERVICES ORGANIZATION
Entity Type:Organization
Organization Name:CHICAGOLAND'S MEDICAL SERVICES ORGANIZATION
Other - Org Name:CMSO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:V
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-868-2080
Mailing Address - Street 1:4415 HARRISON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-1953
Mailing Address - Country:US
Mailing Address - Phone:773-868-2030
Mailing Address - Fax:888-972-1803
Practice Address - Street 1:4415 HARRISON ST STE 300
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-1953
Practice Address - Country:US
Practice Address - Phone:773-868-2030
Practice Address - Fax:888-972-1803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-31
Last Update Date:2015-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization