Provider Demographics
NPI:1598403313
Name:CORI CORPORATION
Entity Type:Organization
Organization Name:CORI CORPORATION
Other - Org Name:REIGN-BOW TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CORITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-573-8587
Mailing Address - Street 1:1919 S HIGHLAND AVE STE 260C
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6174
Mailing Address - Country:US
Mailing Address - Phone:630-448-2721
Mailing Address - Fax:
Practice Address - Street 1:1919 S HIGHLAND AVE STE 210C
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6160
Practice Address - Country:US
Practice Address - Phone:773-573-8587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000OtherN/A