Organization
CJC SERVICES UNLIMITED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORY M QUERUBIN MHA (ASSISTANT AGENCY MANAGER)
(833) 527-3252
Entity
Organization
Contact information
Practice address
222 E WISCONSIN AVE, SUITE 205, LAKE FOREST, IL 60045
(833) 527-3252
Mailing address
222 E WISCONSIN AVE, SUITE 205, LAKE FOREST, IL 60045
(833) 527-3252
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3001856
IDPH LICENSE
IL
Enumeration date
01/23/2024
Last updated
03/25/2024
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