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General NPI Number Information
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NPI Number | 1265719694
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Entity Type | Organization
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Legal Business Name | HELPSOURCE OF NORTH SHORE DBA COMFORT KEEPERS
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 310 N WOLF RD
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City | WHEELING
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State | IL
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Zip | 60090-2924
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Country | US
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Telephone | 847-215-8550
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Fax | 847-215-7941
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Provider Business Mailing Address
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Address Line | 310 N WOLF RD
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City | WHEELING
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State | IL
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Zip | 60090-2924
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Country | US
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Telephone | 847-215-8550
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Fax | 847-215-7941
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Authorized Official
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Title or Position | OWNER
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Name | SOFIYA ABIL
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Credential |
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Telephone | 847-215-8550
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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 | HSA 3000105
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License Number State | IL
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