Healthcare Provider Details
I. General information
NPI: 1235614926
Provider Name (Legal Business Name): ALC PALLIATIVE AND HOSPICE CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2018
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
360 W BUTTERFIELD RD STE 325
ELMHURST IL
60126-5088
US
IV. Provider business mailing address
360 W BUTTERFIELD RD STE 325
ELMHURST IL
60126-5088
US
V. Phone/Fax
- Phone: 630-480-6887
- Fax: 630-480-6808
- Phone: 630-480-6887
- Fax: 630-480-6808
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ANTHONY
SICILIANO
Title or Position: OWNER
Credential:
Phone: 630-480-6887