Provider Demographics
NPI:1649305731
Name:PARTNERS IN RECOVERY LTD
Entity type:Organization
Organization Name:PARTNERS IN RECOVERY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:708-957-3303
Mailing Address - Street 1:18208 DOLPHIN LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1507
Mailing Address - Country:US
Mailing Address - Phone:708-957-3303
Mailing Address - Fax:708-957-3764
Practice Address - Street 1:18208 DOLPHIN LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1507
Practice Address - Country:US
Practice Address - Phone:708-957-3303
Practice Address - Fax:708-957-3764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01633198OtherBCBS