Healthcare Provider Details

I. General information

NPI: 1063191658
Provider Name (Legal Business Name): UNITY HOSPICE GSL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6406 WISE AVE
SAINT LOUIS MO
63139-3315
US

IV. Provider business mailing address

4101 MAIN ST
SKOKIE IL
60076-2753
US

V. Phone/Fax

Practice location:
  • Phone: 847-982-1800
  • Fax:
Mailing address:
  • Phone: 847-982-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ELI KLEIN
Title or Position: CFO
Credential:
Phone: 847-982-1800