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General NPI Number Information
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NPI Number | 1679518898
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTHCARE MANAGEMENT, INC.
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 6232 N PULASKI RD SUITE 404
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City | CHICAGO
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State | IL
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Zip | 60646-5132
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Country | US
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Telephone | 773-628-7493
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Fax | 773-628-7503
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Provider Business Mailing Address
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Address Line | 2720 S RIVER RD SUITE 233
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City | DES PLAINES
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State | IL
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Zip | 60018-4106
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Country | US
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Telephone | 773-628-7493
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Fax | 773-628-7503
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LORELIE PARADERO
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Credential | RN, BSN
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Telephone | 773-628-7493
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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 | 1010291
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License Number State | IL
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