<Unavail>

LBN: Proviso Family Services
<Unavail> is an health care organization with primary practice located at 100 N River Rd , Des Plaines IL 60016-1209. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Proviso Family Services can be contacted via phone (708) 338-3806, or through Kamiski, Kristin via phone (708) 338-3806.

Contact Information

Primary practice address
100 N River Rd Des Plaines IL 60016-1209
Phone: (708) 338-3806
Fax: (708) 681-1289
Website:
Map and Directions
Authorized official contact:
Name: Kamiski, Kristin
Phone: (708) 338-3806

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1588810550
LBN Legal business name Proviso Family Services
DBA Doing business as <Unavail>
Authorized official Kamiski, Kristin
Entity Organization
Organization subpart 1 No
Enumeration date Aug 11th, 2008
Last updated Aug 11th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588810550 NPPES
Illinois Other 1616027 BCBS

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