Healthcare Provider Details

I. General information

NPI: 1871003335
Provider Name (Legal Business Name): CENTER FOR SENIORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 10/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 CAPITOL DR
WHEELING IL
60090-7203
US

IV. Provider business mailing address

8900 CAPITOL DR
WHEELING IL
60090-7203
US

V. Phone/Fax

Practice location:
  • Phone: 847-465-9999
  • Fax: 847-465-9949
Mailing address:
  • Phone: 847-465-9999
  • Fax: 847-465-9949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberADS1813010
License Number StateIL

VIII. Authorized Official

Name: MR. INCHUL CHOI
Title or Position: ASSOCIATE DIRECTOR
Credential:
Phone: 773-478-1245