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General NPI Number Information
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NPI Number | 1699939645
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Entity Type | Organization
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Legal Business Name | GUARDIAN HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 07/17/2008
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Provider Practice Location Address
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Address Line | 7132 N HARLEM AVENUE SUITE 107
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City | CHICAGO
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State | IL
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Zip | 60631-1086
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Country | US
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Telephone | 773-631-7975
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Fax | 773-631-7965
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Provider Business Mailing Address
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Address Line | 7132 N HARLEM AVENUE SUITE 107
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City | CHICAGO
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State | IL
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Zip | 60631-1086
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Country | US
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Telephone | 773-631-7975
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Fax | 773-631-7965
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MS. CARMELITA PATOLOT MAYER
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Credential | R.N.
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Telephone | 773-746-4525
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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 | 1010780
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License Number State | IL
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