Healthcare Provider Details

I. General information

NPI: 1861680092
Provider Name (Legal Business Name): CARESERVICES OF ILLINOIS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 05/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 W CENTRAL RD 404
ARLINGTON HEIGHTS IL
60005-2402
US

IV. Provider business mailing address

2400 HIGH RIDGE RD SUITE 101 AND 103
BOYNTON BEACH FL
33426-8725
US

V. Phone/Fax

Practice location:
  • Phone: 847-506-3100
  • Fax: 847-506-0336
Mailing address:
  • Phone: 561-244-0220
  • Fax: 561-244-0221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number216516
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number216516
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number101727
License Number StateIL

VIII. Authorized Official

Name: MAXINE HOCHHAUSER
Title or Position: CEO
Credential:
Phone: 561-244-3672