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General NPI Number Information
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NPI Number | 1629341029
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Entity Type | Organization
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Legal Business Name | DIGNITY HOMESERVICES
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Dates
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Enumeration Date | 02/15/2012
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Last Update Date | 02/23/2012
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Provider Practice Location Address
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Address Line | 456 W FRONTAGE RD SUITE 8
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City | NORTHFIELD
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State | IL
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Zip | 60093-3034
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Country | US
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Telephone | 847-386-6857
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Fax | 847-386-6859
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Provider Business Mailing Address
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Address Line | 456 W FRONTAGE RD SUITE 8
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City | NORTHFIELD
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State | IL
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Zip | 60093-3034
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Country | US
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Telephone | 847-386-6857
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Fax | 847-386-6859
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. IGOR MAKAROV
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Credential |
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Telephone | 224-545-8728
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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 | 2033416
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License Number State | IL
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