Healthcare Provider Details

I. General information

NPI: 1588280499
Provider Name (Legal Business Name): GERIATRIC SR CARE HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 MILWAUKEE AVE STE 360
DEERFIELD IL
60015-3561
US

IV. Provider business mailing address

1020 MILWAUKEE AVE STE 360
DEERFIELD IL
60015-3561
US

V. Phone/Fax

Practice location:
  • Phone: 224-764-2240
  • Fax: 224-764-2241
Mailing address:
  • Phone: 224-764-2240
  • Fax: 224-764-2241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK ARROJO
Title or Position: PRESIDENT
Credential:
Phone: 224-764-2240