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General NPI Number Information
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NPI Number | 1568556793
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Entity Type | Organization
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Legal Business Name | CHALICE HOME HEALTH CARE
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 7136 W GRAND AVE
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City | CHICAGO
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State | IL
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Zip | 60707-2805
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Country | US
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Telephone | 773-622-7140
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Fax | 773-622-7442
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Provider Business Mailing Address
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Address Line | 7136 W GRAND AVE
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City | CHICAGO
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State | IL
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Zip | 60707-2805
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Country | US
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Telephone | 773-622-7140
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Fax | 773-622-7442
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIRGILIO M ORILLO
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Credential | M.D.
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Telephone | 773-622-7140
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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 | 147787
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License Number State | IL
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