Provider Demographics
NPI:1962819987
Name:CLINICAL SPECIALTIES NETWORK SERVICES OF ILLINOIS
Entity Type:Organization
Organization Name:CLINICAL SPECIALTIES NETWORK SERVICES OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT /CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-879-6137
Mailing Address - Street 1:6288 HUDSON CROSSING PKWY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4347
Mailing Address - Country:US
Mailing Address - Phone:440-717-1700
Mailing Address - Fax:440-717-1705
Practice Address - Street 1:6288 HUDSON CROSSING PKWY
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4347
Practice Address - Country:US
Practice Address - Phone:440-717-1700
Practice Address - Fax:440-717-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health