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General NPI Number Information
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NPI Number | 1871949842
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Entity Type | Organization
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Legal Business Name | HAWKINS CILA CARE CORPORATION
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 8340 S PAULINA ST
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City | CHICAGO
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State | IL
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Zip | 60620-4635
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Country | US
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Telephone | 708-250-0603
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Fax |
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Provider Business Mailing Address
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Address Line | 20230 MOHAWK TRL
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1134
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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 | DIRECTOR/OWNER
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Name | JANICE PRESTON
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Credential |
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Telephone | 708-250-0603
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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 | 201600003C
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License Number State | IL
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