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General NPI Number Information
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NPI Number | 1609293653
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Entity Type | Organization
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Legal Business Name | IGOCARE, INC
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 6352 N LINCOLN AVE 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60659-1213
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Country | US
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Telephone | 773-775-4677
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Fax | 773-775-4687
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Provider Business Mailing Address
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Address Line | 6352 N LINCOLN AVE 2ND FLOOR
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City | CHICAGO
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State | IL
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Zip | 60659-1213
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Country | US
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Telephone | 773-775-4677
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Fax | 773-775-4687
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Authorized Official
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Title or Position | GENERAL MANAGER, OWNER
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Name | MRS. HEATHER ANN LANTRY
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Credential | NCC, MT-BC, NMT
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Telephone | 773-775-4677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3001019
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License Number State | IL
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