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General NPI Number Information
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NPI Number | 1881076016
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Entity Type | Organization
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Legal Business Name | WINDSOR HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 77 W WASHINGTON ST SUITE 1204
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City | CHICAGO
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State | IL
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Zip | 60602-2801
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Country | US
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Telephone | 312-263-1288
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Fax | 312-251-1281
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Provider Business Mailing Address
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Address Line | 77 W WASHINGTON ST SUITE 1204
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City | CHICAGO
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State | IL
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Zip | 60602-2801
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Country | US
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Telephone | 312-263-1288
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Fax | 312-251-1281
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL O OTUBUSIN
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Credential | PHD, JD
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Telephone | 312-263-1288
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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 | 3001223
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License Number State | IL
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