MEDICARE: LITTLE SISTERS OF THE POOR CHICAGO INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174652176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE SISTERS OF THE POOR CHICAGO INC

Provider Business Mailing Address
First Line	:	2325 N LAKEWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3112
Country	:	US
Telephone Number	:	773-935-9600
Fax Number	:	773-935-4291

Provider Business Practice Location Address
First Line	:	2325 N LAKEWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3112
Country	:	US
Telephone Number	:	773-935-9600
Fax Number	:	773-935-4291

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLAIRE MCCANLESS
Credential	:
Telephone Number	:	773-935-9600

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	12/18/2017

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