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General NPI Number Information
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NPI Number | 1043961642
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Entity Type | Organization
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Legal Business Name | NURSES ON WHEELS HOMESERVICES LLC
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Dates
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Enumeration Date | 01/14/2022
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 11001 S MICHIGAN AVE STE 105
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City | CHICAGO
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State | IL
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Zip | 60628-4308
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Country | US
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Telephone | 773-313-9040
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Fax |
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Provider Business Mailing Address
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Address Line | 11001 S MICHIGAN AVE STE 105
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City | CHICAGO
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State | IL
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Zip | 60628-4308
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Country | US
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Telephone | 773-313-9040
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALESIA BOYD CARLOCK
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Credential |
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Telephone | 773-313-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2400X
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Taxonomy Name | Prison Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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