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General NPI Number Information
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NPI Number | 1669743100
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Entity Type | Organization
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Legal Business Name | CARE AT HOME
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 7115 S SAWYER AVE
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City | CHICAGO
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State | IL
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Zip | 60629-3535
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Country | US
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Telephone | 773-980-3268
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Fax | 773-778-5433
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Provider Business Mailing Address
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Address Line | 7115 S SAWYER AVE
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City | CHICAGO
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State | IL
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Zip | 60629-3535
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Country | US
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Telephone | 773-980-3268
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Fax | 773-778-5433
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Authorized Official
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Title or Position | CEO
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Name | MS. AGNES COLLIER
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Credential | CNA
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Telephone | 773-209-7316
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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 | 2129082
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License Number State | IL
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