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General NPI Number Information
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NPI Number | 1740230622
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Entity Type | Organization
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Legal Business Name | CLASSIC HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 11/15/2007
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Provider Practice Location Address
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Address Line | 2200 S MAIN ST SUITE 300
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-620-9251
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Fax | 630-620-9254
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Provider Business Mailing Address
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Address Line | 2200 S MAIN ST SUITE 300
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City | LOMBARD
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State | IL
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Zip | 60148-5334
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Country | US
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Telephone | 630-620-9251
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Fax | 630-620-9254
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MRS. ROSALYN SANCHEZ MAGSINO
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Credential | R.N.
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Telephone | 630-620-9251
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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 | 1010558
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License Number State | IL
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