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General NPI Number Information
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NPI Number | 1538546825
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Entity Type | Organization
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Legal Business Name | GERICARE ASSOCIATES, SC.
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 6201 W TOUHY AVE
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City | CHICAGO
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State | IL
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Zip | 60646-1100
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Country | US
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Telephone | 847-673-5166
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Fax | 847-673-5636
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Provider Business Mailing Address
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Address Line | 6201 W TOUHY AVE
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City | CHICAGO
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State | IL
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Zip | 60646-1100
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Country | US
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Telephone | 847-462-4411
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Fax | 847-462-4411
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABDULMASSIH ABDULMASSIH
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Credential | M.D.
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Telephone | 847-922-4221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 36-086946
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License Number State | IL
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