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General NPI Number Information
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NPI Number | 1851252597
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Entity Type | Organization
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Legal Business Name | KLC INDEPENDENT LIVING
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Dates
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Enumeration Date | 11/21/2025
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 1717 W GARFIELD BLVD
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City | CHICAGO
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State | IL
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Zip | 60636-1210
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Country | US
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Telephone | 312-545-4089
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Fax |
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Provider Business Mailing Address
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Address Line | 1717 W GARFIELD BLVD
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City | CHICAGO
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State | IL
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Zip | 60636-1210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KANDACE CURTISS
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Credential | DR
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Telephone | 773-396-8610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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