Provider Demographics
NPI:1487910139
Name:COMPREHENSIVE ADVANCED PRACTICE SERVICES, INC.
Entity type:Organization
Organization Name:COMPREHENSIVE ADVANCED PRACTICE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:630-981-7589
Mailing Address - Street 1:538 S LODGE LN
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-2945
Mailing Address - Country:US
Mailing Address - Phone:630-981-7589
Mailing Address - Fax:630-748-2063
Practice Address - Street 1:538 S LODGE LN
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2945
Practice Address - Country:US
Practice Address - Phone:630-981-7589
Practice Address - Fax:630-748-2063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003579363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty