Healthcare Provider Details

I. General information

NPI: 1780339853
Provider Name (Legal Business Name): UNIQUE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2022
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7210 S CHAMPLAIN AVE
CHICAGO IL
60619-1220
US

IV. Provider business mailing address

7210 S CHAMPLAIN AVE
CHICAGO IL
60619-1220
US

V. Phone/Fax

Practice location:
  • Phone: 773-679-0208
  • Fax:
Mailing address:
  • Phone: 773-679-0208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: EDIE N. TURNER
Title or Position: PRESIDENT
Credential:
Phone: 312-225-3800