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General NPI Number Information
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NPI Number | 1386153583
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH INFORMATION NETWORK
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Dates
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Enumeration Date | 09/20/2017
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 5757 N LINCOLN AVE STE 15
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City | CHICAGO
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State | IL
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Zip | 60659-4729
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Country | US
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Telephone | 612-306-4843
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Fax |
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Provider Business Mailing Address
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Address Line | 5757 N LINCOLN AVE STE 15
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City | CHICAGO
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State | IL
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Zip | 60659-4729
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Country | US
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Telephone | 877-981-6500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARY LOUISE GAINES
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Credential |
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Telephone | 612-306-4843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | IL
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Taxonomy #6
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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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Taxonomy #7
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | IL
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Taxonomy #10
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State | IL
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