Healthcare Provider Details

I. General information

NPI: 1740697754
Provider Name (Legal Business Name): HOPE HEALTH CARE OF CHICAGO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018 N GRANT ST
WESTMONT IL
60559-1314
US

IV. Provider business mailing address

4018 N GRANT ST
WESTMONT IL
60559-1314
US

V. Phone/Fax

Practice location:
  • Phone: 630-796-1560
  • Fax:
Mailing address:
  • Phone: 630-796-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIL

VIII. Authorized Official

Name: JULIETTE KOHOU KOUI
Title or Position: CO-OWNER
Credential:
Phone: 630-796-1560