Healthcare Provider Details

I. General information

NPI: 1801802012
Provider Name (Legal Business Name): CARE CENTERS HEALTH SYSTEMS LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOWARD AVE SUITE 250
DES PLAINES IL
60018-5906
US

IV. Provider business mailing address

200 HOWARD AVE STE 250
DES PLAINES IL
60018-5909
US

V. Phone/Fax

Practice location:
  • Phone: 224-612-5662
  • Fax: 224-612-5862
Mailing address:
  • Phone: 224-612-5662
  • Fax: 224-612-5862

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number203.00378
License Number StateIL

VIII. Authorized Official

Name: MR. YISHAI BRONER
Title or Position: MANAGER
Credential:
Phone: 224-612-5680