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General NPI Number Information
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NPI Number | 1750461604
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Entity Type | Organization
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Legal Business Name | SULIT CORPORATION
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 3415 N ODELL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-3440
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Country | US
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Telephone | 773-836-9306
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Fax |
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Provider Business Mailing Address
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Address Line | 3415 N ODELL AVE
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City | CHICAGO
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State | IL
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Zip | 60634-3440
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Country | US
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Telephone | 773-836-9306
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | LEILANI SULIT
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Credential |
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Telephone | 773-836-9306
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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 | 1009208
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License Number State | IL
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