Organization
ALCOHOL CHEMICAL EVALUATION SERVICES
Active
Other names
ACES
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI ANN DRIVER-DIXON (OFFICE MANAGER)
(217) 344-2671
Entity
Organization
Contact information
Practice address
217 N BROADWAY AVE, URBANA, IL 61801-2706
(217) 344-2671
(217) 344-2819
Mailing address
217 N BROADWAY AVE, URBANA, IL 61801-2706
(217) 344-2671
(217) 344-2819
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
A-7511-0001-A
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001032040
BLUE SHIELD ID #
IL
Enumeration date
05/10/2007
Last updated
10/06/2008
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