Organization Active NPI

Enhanced Clinical Solutions, Inc

  • Community/Behavioral Health Agency
  • Maywood, IL
National Provider Identifier
1255508941
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
A-4749-0001-A Issued in IL
Legal business name
ENHANCED CLINICAL SOLUTIONS, INC
Practice address
1701 S 1St Ave
Suite# 310
Maywood, IL 60153-2442
Phone
(708) 344-0884
Fax
(708) 343-5629
NPI assigned
May 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Frank Michael Jordan
Title
President
Phone
(708) 344-0884

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X A-4749-0001-A IL Primary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X A-4749-0001-A IL

Addresses

Primary practice location

1701 S 1St Ave
Suite# 310
Maywood, IL 60153-2442

Mailing address

1701 S 1St Ave
Maywood, IL 60153-2442
Phone (708) 344-0884

Other identifiers 1

IdentifierTypeStateIssuer
A-4749-0001-AOtherILDEPARTMENT OF ALCOHOL AND SUBSTANCE ABUSE

National Provider Directory

National Provider Directory

Locations

1701 S 1st Ave
Ste 310
Maywood, IL 60153
Phone (708) 344-0884

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1255508941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532442",
            "telephone_number": "708-344-0884",
            "fax_number": "708-343-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S 1ST AVE",
            "address_2": "SUITE# 310",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601532442",
            "telephone_number": "708-344-0884",
            "fax_number": "708-343-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED CLINICAL SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-12",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-344-0884",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "A-4749-0001-A",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "IL",
            "license": "A-4749-0001-A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF ALCOHOL AND SUBSTANCE ABUSE",
            "identifier": "A-4749-0001-A",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.