Healthcare Provider Details

I. General information

NPI: 1427284686
Provider Name (Legal Business Name): K2 HELPING HANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21645 OLIVIA AVE
SAUK VILLAGE IL
60411-4426
US

IV. Provider business mailing address

21645 OLIVIA AVE
SAUK VILLAGE IL
60411-4426
US

V. Phone/Fax

Practice location:
  • Phone: 708-692-8737
  • Fax: 708-367-9930
Mailing address:
  • Phone: 708-692-8737
  • Fax: 708-367-9930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. SHAWNICE Y WAIGHT
Title or Position: PRESIDENT
Credential:
Phone: 708-692-8737