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General NPI Number Information
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NPI Number | 1215575618
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Entity Type | Organization
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Legal Business Name | HEART OF WISDOM LLC
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 6859 W ADDISON ST STE 6
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City | CHICAGO
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State | IL
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Zip | 60634-3704
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Country | US
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Telephone | 800-501-8218
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Fax |
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Provider Business Mailing Address
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Address Line | 6859 W ADDISON ST STE 6
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City | CHICAGO
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State | IL
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Zip | 60634-3704
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Country | US
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Telephone | 800-501-8218
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | PATRICK AROB NONO
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Credential |
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Telephone | 224-651-6685
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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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