Healthcare Provider Details

I. General information

NPI: 1124593439
Provider Name (Legal Business Name): TOTAL SENIOR CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 GEORGETOWN SQ STE 106
WOOD DALE IL
60191-1890
US

IV. Provider business mailing address

330 GEORGETOWN SQ STE 106
WOOD DALE IL
60191-1890
US

V. Phone/Fax

Practice location:
  • Phone: 630-422-7118
  • Fax: 630-422-1073
Mailing address:
  • Phone: 630-422-7118
  • Fax: 630-422-1073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ANGELA MAROULIS
Title or Position: PRESIDENT
Credential:
Phone: 630-422-7118