Healthcare Provider Details

I. General information

NPI: 1619921566
Provider Name (Legal Business Name): COUNCIL FOR JEWISH ELDERLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 HOWARD ST
EVANSTON IL
60202-3823
US

IV. Provider business mailing address

3003 W TOUHY AVE
CHICAGO IL
60645-2833
US

V. Phone/Fax

Practice location:
  • Phone: 773-508-1000
  • Fax: 773-508-1028
Mailing address:
  • Phone: 773-508-1000
  • Fax: 773-508-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code343800000X
TaxonomySecured Medical Transport (VAN)
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateIL

VIII. Authorized Official

Name: STACEY LEE TURNER
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 773-508-1075