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General NPI Number Information
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NPI Number | 1376094482
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Entity Type | Organization
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Legal Business Name | ALC STAFFING, LLC DBA ALC HOME SERVICES
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 10/24/2016
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Provider Practice Location Address
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Address Line | 477 E BUTTERFIELD RD SUITE 400B
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City | LOMBARD
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State | IL
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Zip | 60148-5618
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Country | US
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Telephone | 630-368-1102
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Fax | 630-368-1104
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Provider Business Mailing Address
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Address Line | 477 E BUTTERFIELD RD SUITE 400B
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City | LOMBARD
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State | IL
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Zip | 60148-5618
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Country | US
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Telephone | 630-368-1102
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Fax | 630-368-1104
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Authorized Official
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Title or Position | CEO
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Name | MR. ANTHONY SICILIANO
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Credential |
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Telephone | 630-368-1102
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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 | 3000882
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License Number State | IL
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