Organization
SUNRISE CONSULTANT SERVICES, INC
Active
Organization
SUNRISE CONSULTANT SERVICES, INC
Active
Other names
Sunrise Clinical Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
YVETTA L MASSEY YVETTA L MASSEY (MSN, RN)
(708) 880-1397
Entity
Organization
Contact information
Practice address
502 W 138TH STREET, RIVERDALE, IL 60827-6082
(312) 778-4258
(708) 880-1239
Mailing address
502 W 138TH STREET, RIVERDALE, IL 60827
(312) 778-4258
(708) 880-1239
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
041265569
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12141960
FAMILY MEDICINE
IL
Enumeration date
07/20/2018
Last updated
07/20/2018
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