Organization
MOBILE ENRICHMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON KOTAS (CFO)
(224) 413-3927
Entity
Organization
Contact information
Practice address
385 MILLENNIUM DR, CRYSTAL LAKE, IL 60012-3761
(847) 816-7200
(847) 816-7210
Mailing address
854 TECHNOLOGY WAY, LIBERTYVILLE, IL 60048-5350
(847) 816-7200
(847) 816-7210
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056.007545
IL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/03/2011
Last updated
02/09/2024
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