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General NPI Number Information
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NPI Number | 1982914123
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Entity Type | Organization
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Legal Business Name | GLOBCARE, INC
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 4747 W PETERSON AVE SUITE 105
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City | CHICAGO
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State | IL
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Zip | 60646-5712
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Country | US
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Telephone | 773-725-8809
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Fax | 772-725-4202
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Provider Business Mailing Address
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Address Line | 4747 W PETERSON AVE SUITE 105
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City | CHICAGO
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State | IL
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Zip | 60646-5712
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Country | US
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Telephone | 773-725-8809
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Fax | 772-725-4202
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KRZYSZTOF KULAGA
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Credential | P.T.
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Telephone | 773-725-8809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | 58488
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License Number State | IL
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