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General NPI Number Information
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NPI Number | 1326137241
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Entity Type | Organization
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Legal Business Name | EVANGELICAL RETIREMENT HOMES OF GREATER CHICAGO
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 350 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3464
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Country | US
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Telephone | 847-884-5040
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Fax | 847-884-5368
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Provider Business Mailing Address
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Address Line | 350 W SCHAUMBURG RD
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City | SCHAUMBURG
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State | IL
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Zip | 60194-3464
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Country | US
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Telephone | 847-884-5040
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Fax | 847-884-5368
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. DAVID A. LOOP
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Credential |
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Telephone | 847-755-2022
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1003334
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License Number State | IL
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