Organization
COVENANT HOLISTIC HEALTHCARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SCOTT (SECRETARY)
(630) 310-2235
Entity
Organization
Contact information
Practice address
2388 RIVER HILLS LN, BOLINGBROOK, IL 60490-4937
(630) 310-2235
(630) 226-5699
Mailing address
2388 RIVER HILLS LN, BOLINGBROOK, IL 60490-4937
(630) 310-2235
(630) 226-5699
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL3719
MEDICARE PTAN
—
Enumeration date
04/26/2012
Last updated
04/26/2012
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