NPI: 1598810764
Provider Name: CORNELL INTERVENTIONS, LLC
Former Legal Business Name: CORNELL INTERVENTIONS, INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization
Specialization: Rehabilitation, Substance Use Disorder
CLIA Number: 14D0987994
Address:
5701 S WOOD ST
CHICAGO, IL
ZIP 60636
Phone: (773) 737-4600
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CORNELL INTERVENTIONS, LLC is a rehabilitation and substance use disorder clinic center in Chicago, IL. CORNELL INTERVENTIONS, LLC NPI is 1598810764. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Cornell Interventions, Inc..
The provider's business location address is:
5701 S WOOD ST
CHICAGO, IL
ZIP 60636-646
Phone: (773) 737-4600
The provider's authorized official is Shayna Alyssa Raver .
The authorized official title is Contracts Director and has the following contact phone number (412) 201-4112.
The CLIA number assigned to this NPI record is 14D0987994 - other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/25/2007 and was last updated on 2/14/2022.