Provider Demographics
NPI:1619749884
Name:CPO SERVICES, INC.
Entity Type:Organization
Organization Name:CPO SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF REVENUE CYCLE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MICKELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-285-7752
Mailing Address - Street 1:741 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61606-1953
Mailing Address - Country:US
Mailing Address - Phone:309-285-7752
Mailing Address - Fax:309-285-7752
Practice Address - Street 1:300 VILLAGE GREEN DRIVE
Practice Address - Street 2:SUITE 205
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069
Practice Address - Country:US
Practice Address - Phone:847-603-8854
Practice Address - Fax:847-238-3096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CPO SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier