Healthcare Provider Details

I. General information

NPI: 1679817647
Provider Name (Legal Business Name): PLOWS COUNCIL ON AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 11/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7808 W COLLEGE DR SUITE 5 EAST
PALOS HEIGHTS IL
60463-1027
US

IV. Provider business mailing address

7808 W COLLEGE DR SUITE 5 EAST
PALOS HEIGHTS IL
60463-1027
US

V. Phone/Fax

Practice location:
  • Phone: 708-361-0219
  • Fax: 708-361-9853
Mailing address:
  • Phone: 708-361-0219
  • Fax: 708-361-9853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD E CHAPMAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 708-361-0219