Healthcare Provider Details

I. General information

NPI: 1063316321
Provider Name (Legal Business Name): LISTENCARE HEALTH NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 N LAKE SHORE DR APT 1401
CHICAGO IL
60611-7428
US

IV. Provider business mailing address

530 N LAKE SHORE DR APT 1401
CHICAGO IL
60611-7428
US

V. Phone/Fax

Practice location:
  • Phone: 312-909-4379
  • Fax:
Mailing address:
  • Phone: 312-909-4379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: YOLANDE DELPHINE WILSON-STUBBS
Title or Position: CEO
Credential:
Phone: 504-382-1330