Provider Demographics
NPI:1811257595
Name:COMMUNITY NUTRITION NETWORK AND SENIOR SERVICES ASSOC COOK COUNTY
Entity type:Organization
Organization Name:COMMUNITY NUTRITION NETWORK AND SENIOR SERVICES ASSOC COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MCLONE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-207-5290
Mailing Address - Street 1:3239 GROVE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3468
Mailing Address - Country:US
Mailing Address - Phone:312-207-5290
Mailing Address - Fax:312-441-0641
Practice Address - Street 1:3239 GROVE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3468
Practice Address - Country:US
Practice Address - Phone:312-207-5290
Practice Address - Fax:312-441-0641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-29
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals