Provider Demographics
NPI:1669654406
Name:CITIA HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:CITIA HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNTON-RACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-272-1788
Mailing Address - Street 1:181 N ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-6157
Mailing Address - Country:US
Mailing Address - Phone:630-272-1788
Mailing Address - Fax:630-679-0038
Practice Address - Street 1:181 N ORCHARD DR
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-6157
Practice Address - Country:US
Practice Address - Phone:630-272-1788
Practice Address - Fax:630-679-0038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty