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General NPI Number Information
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NPI Number | 1760136378
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Entity Type | Organization
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Legal Business Name | CHERUB CARES
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Dates
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Enumeration Date | 02/11/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 4747 W PETERSON AVE STE 300
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City | CHICAGO
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State | IL
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Zip | 60646-5770
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Country | US
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Telephone | 773-647-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4207 W JARVIS AVE
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-1905
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Country | US
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Telephone | 847-567-0578
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. LES CHERUVATHOOR
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Credential |
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Telephone | 847-567-0578
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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 |
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License Number State |
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