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General NPI Number Information
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NPI Number | 1407429111
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Entity Type | Organization
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Legal Business Name | CHOSEN HOME CARE LLC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 1200 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60622-2259
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Country | US
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Telephone | 847-641-8956
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 GOLF RD APT 211
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City | WAUKEGAN
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State | IL
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Zip | 60087-3848
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Country | US
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Telephone | 847-641-8956
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MISS AYESHA SCONYERS
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Credential |
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Telephone | 847-641-8956
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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