Provider Demographics
NPI:1598905713
Name:OAK TREE CLINICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:OAK TREE CLINICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:630-258-7866
Mailing Address - Street 1:331 WHITE HALL TER
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1384
Mailing Address - Country:US
Mailing Address - Phone:630-258-7866
Mailing Address - Fax:
Practice Address - Street 1:129 FAIRFIELD WAY
Practice Address - Street 2:SUITE 208C
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1560
Practice Address - Country:US
Practice Address - Phone:630-258-7866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005451251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health