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General NPI Number Information
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NPI Number | 1114599099
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Entity Type | Organization
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Legal Business Name | CAPITAL CARE
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Dates
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Enumeration Date | 07/12/2021
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 235 REMINGTON BLVD STE L
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3687
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Country | US
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Telephone | 630-344-2742
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Fax | 630-410-2630
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Provider Business Mailing Address
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Address Line | 528 ROCK SPRING CT
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City | NAPERVILLE
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State | IL
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Zip | 60565-5344
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Country | US
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Telephone | 630-344-2742
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Fax | 630-410-2630
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Authorized Official
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Title or Position | CEO
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Name | SHAZIA F KHAN
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Credential |
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Telephone | 630-344-2742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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