Healthcare Provider Details
I. General information
NPI: 1407370810
Provider Name (Legal Business Name): INSITA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N MICHIGAN AVE STE 600
CHICAGO IL
60611-3754
US
IV. Provider business mailing address
500 N MICHIGAN AVE STE 600
CHICAGO IL
60611-3754
US
V. Phone/Fax
- Phone: 312-509-9111
- Fax:
- Phone: 312-509-9111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SRI
KALAPALA
Title or Position: CEO
Credential:
Phone: 412-897-1587