Healthcare Provider Details

I. General information

NPI: 1699493577
Provider Name (Legal Business Name): CLADDAGH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/21/2022
Certification Date: 08/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 W SUMMERDALE AVE
CHICAGO IL
60656-1554
US

IV. Provider business mailing address

8000 W SUMMERDALE AVE
CHICAGO IL
60656-1554
US

V. Phone/Fax

Practice location:
  • Phone: 773-312-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: ROSEMARIE CONNOLLY
Title or Position: PRESIDENT
Credential:
Phone: 773-312-7711