Healthcare Provider Details

I. General information

NPI: 1982914123
Provider Name (Legal Business Name): GLOBCARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 10/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 W PETERSON AVE SUITE 105
CHICAGO IL
60646-5712
US

IV. Provider business mailing address

4747 W PETERSON AVE SUITE 105
CHICAGO IL
60646-5712
US

V. Phone/Fax

Practice location:
  • Phone: 773-725-8809
  • Fax: 772-725-4202
Mailing address:
  • Phone: 773-725-8809
  • Fax: 772-725-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number58488
License Number StateIL

VIII. Authorized Official

Name: MR. KRZYSZTOF KULAGA
Title or Position: PRESIDENT
Credential: P.T.
Phone: 773-725-8809