Provider Demographics
NPI:1578878468
Name:THE EVANGELICAL ALLIANCE MISSION
Entity Type:Organization
Organization Name:THE EVANGELICAL ALLIANCE MISSION
Other - Org Name:TEAM
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:ELMER
Authorized Official - Middle Name:
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-653-5300
Mailing Address - Street 1:400 S MAIN PL
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2407
Mailing Address - Country:US
Mailing Address - Phone:630-653-5300
Mailing Address - Fax:
Practice Address - Street 1:400 S MAIN PL
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2407
Practice Address - Country:US
Practice Address - Phone:630-653-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.152199251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable