Provider Demographics
NPI:1578991386
Name:CHOICE CLINICAL SERVICES INC.
Entity Type:Organization
Organization Name:CHOICE CLINICAL SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:815-405-5858
Mailing Address - Street 1:21415 WOODED COVE DR
Mailing Address - Street 2:
Mailing Address - City:ELWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60421-9612
Mailing Address - Country:US
Mailing Address - Phone:815-405-5858
Mailing Address - Fax:
Practice Address - Street 1:1938 E LINCOLN HWY
Practice Address - Street 2:SUITE 294
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-3810
Practice Address - Country:US
Practice Address - Phone:815-405-5858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490098441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty