Organization
LESTER & ROSALIE ANIXTER CENTER
Active
Other names
Anixter Center at Parkshore
Organization subpart
No
Provider details
NPI number
Authorized official
MARY DESMOND (DIRECTOR OF FINANCE)
(773) 761-1501
Entity
Organization
Contact information
Practice address
6125 S KENWOOD AVE, CHICAGO, IL 60637-2818
(773) 752-6000
(773) 274-3523
Mailing address
6610 N CLARK ST, CHICAGO, IL 60626-4062
(773) 761-1501
(773) 274-3523
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A-0998-0012-A
—
IL
Enumeration date
07/17/2018
Last updated
07/17/2018
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