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Organization

SOUTH SIDE CHRISTIAN COUNSELING CENTER GROUP

Active
Other names
Southside Christian Counseling Center
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY S HAUSER (PRESIDENT)
(712) 887-0399
Entity
Organization

Contact information

Practice address
16537 OAK PARK AVE., TINLEY PARK, IL 60477
(708) 633-9003
(708) 633-1823
Mailing address
408 MAIN ST., LOHRVILLE, IA 51453
(712) 887-0399
(708) 633-1823

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
180-003931
IL
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1618179
BLUE CROSS BLUE SHIELD
IL
01
7092108
AETNA INSURANCE
IL
Enumeration date
08/01/2006
Last updated
06/12/2015
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