Healthcare Provider Details
I. General information
NPI: 1245631860
Provider Name (Legal Business Name): HOPE HOSPICE AND PALLIATIVE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2014
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2315 E 93RD ST SUITE 237B
CHICAGO IL
60617-3936
US
IV. Provider business mailing address
2315 E 93RD ST 237B
CHICAGO IL
60617-3936
US
V. Phone/Fax
- Phone: 773-734-9200
- Fax: 773-734-9201
- Phone: 773-734-9200
- Fax: 773-734-9201
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | 2003081 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AKHTAR
PARVAIZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-734-9200