Organization Active NPI

Cornerstone Clinical & Training Services, Inc.

  • Counselor
  • Chicago, IL
National Provider Identifier
1689778367
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CORNERSTONE CLINICAL & TRAINING SERVICES, INC.
Practice address
10540 S Western Ave
Suite 501
Chicago, IL 60643-2536
Phone
(708) 291-0079
Fax
(708) 857-9417
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Omotayo Oladejo, MHSNPI 1952458895
Title
President
Phone
(708) 291-0079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X IL Primary

Addresses

Primary practice location

10540 S Western Ave
Suite 501
Chicago, IL 60643-2536

Mailing address

2853 W 98TH PL
Evergreen Park, IL 60805-2614
Phone (708) 291-0079

Other identifiers 3

IdentifierTypeStateIssuer
0001634317OtherILBLUECROSSBLUESHIELD
515000OtherILPSYCHEALTH, LTD
234943OtherILCOMPSYCH

National Provider Directory

National Provider Directory

Locations

10540 S Western Ave
Ste 501
Chicago, IL 60643
Phone (708) 291-0079

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689778367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2853 W 98TH PL",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052614",
            "telephone_number": "708-291-0079",
            "fax_number": "708-857-9417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10540 S WESTERN AVE",
            "address_2": "SUITE 501",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432536",
            "telephone_number": "708-291-0079",
            "fax_number": "708-857-9417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE CLINICAL & TRAINING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLADEJO",
        "authorized_official_first_name": "OMOTAYO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-291-0079",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MHS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "0001634317",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PSYCHEALTH, LTD",
            "identifier": "515000",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "234943",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.