Provider Demographics
NPI:1932870573
Name:GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:GOTTLIEB COMMUNITY HEALTH SERVICES CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:NORTON-ROSKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-216-6143
Mailing Address - Street 1:3249 OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3429
Mailing Address - Country:US
Mailing Address - Phone:888-622-6325
Mailing Address - Fax:
Practice Address - Street 1:3249 OAK PARK AVE # T1201
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3429
Practice Address - Country:US
Practice Address - Phone:708-783-5951
Practice Address - Fax:708-783-5915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy