Healthcare Provider Details

I. General information

NPI: 1861972515
Provider Name (Legal Business Name): LIFECHOICE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2018
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E NORTHWEST HWY STE 526
PALATINE IL
60074-6542
US

IV. Provider business mailing address

800 E NORTHWEST HWY STE 526
PALATINE IL
60074-6542
US

V. Phone/Fax

Practice location:
  • Phone: 847-777-8888
  • Fax: 847-380-7638
Mailing address:
  • Phone: 847-777-8888
  • Fax: 847-380-7638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEXANDER ROSHKO
Title or Position: CEO
Credential:
Phone: 847-571-1771