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General NPI Number Information
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NPI Number | 1962741439
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Entity Type | Organization
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Legal Business Name | HOSPICE SANCTUARY OF ILLINOIS LLC
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 02/04/2013
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Provider Practice Location Address
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Address Line | 3101 N CALIFORNIA AVE SUITE 1N
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City | CHICAGO
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State | IL
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Zip | 60618-7007
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Country | US
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Telephone | 602-330-3000
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Fax | 773-267-5501
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Provider Business Mailing Address
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Address Line | 3101 N CALIFORNIA AVE SUITE 1N
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City | CHICAGO
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State | IL
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Zip | 60618-7007
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Country | US
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Telephone | 602-330-3000
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Fax | 773-267-5501
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL ARDELEAN
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Credential |
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Telephone | 602-330-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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