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General NPI Number Information
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NPI Number | 1447204516
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Entity Type | Organization
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Legal Business Name | TENDER LOVING CARE HEALTH CARE SERVICES OF ILLINOIS, LLC
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Dates
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Enumeration Date | 05/21/2006
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 680 N LAKE SHORE DR STE 920
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-573-0685
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Fax | 312-573-0698
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 225-292-2031
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Fax | 225-295-9678
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Authorized Official
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Title or Position | CEO
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Name | MR. WILLIAM BORNE
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Credential |
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Telephone | 225-292-2031
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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 | 1010533
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License Number State | IL
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