Organization
CISCO THERAPEUTIC SERVICES, INC.
Active
Other names
Kris Cisco
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRIS CISCO LCSW (OWNER)
(815) 741-3009
Entity
Organization
Contact information
Practice address
1520 N ROCK RUN DR, SUITE 30A, CREST HILL, IL 60435-3153
(815) 741-3009
(815) 741-8322
Mailing address
1520 N ROCK RUN DR, SUITE 30A, CREST HILL, IL 60435-3153
(815) 741-3009
(815) 741-8322
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932284
BCBS OF IL PROVIDER #
IL
Enumeration date
08/08/2006
Last updated
08/22/2020
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