NPI 1205666096
Englewood Community Outreach
Practice location
- Address
- 9531 S Utica Avenue, Evergreen Park, IL 60805
- Phone
- (872) 209-1298
- Mailing address
- 9631 S Cicero Ave STE 1356, Oak Lawn, IL 60453-3137
Authorised official
- Name
- Shanta Coppage
- Title
- President
- Phone
- (872) 209-1298
Registered specialties
Day Training/Habilitation Specialist
Primary
Registry record
- NPI
- 1205666096
- Entity type
- Organization
- NPI issued
- 6 Aug 2024
- Record last updated
- 6 Aug 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.