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General NPI Number Information
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NPI Number | 1174308407
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Entity Type | Organization
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Legal Business Name | JKL IN-HOME CARE, LLC
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Dates
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Enumeration Date | 08/25/2023
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Last Update Date | 08/25/2023
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Provider Practice Location Address
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Address Line | 1955 RAYMOND DR STE 108
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City | NORTHBROOK
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State | IL
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Zip | 60062-6731
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Country | US
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Telephone | 847-999-3313
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Fax | 847-999-3309
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Provider Business Mailing Address
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Address Line | 1955 RAYMOND DR STE 108
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City | NORTHBROOK
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State | IL
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Zip | 60062-6731
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Country | US
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Telephone | 847-999-3313
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Fax | 847-999-3309
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MR. JIM LEDERER
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Credential |
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Telephone | 847-999-3313
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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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