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Organization
LAKESHORE SENIOR SERVICES LLC
Active
Organization
LAKESHORE SENIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A VOLINI (PRESIDENT)
(708) 267-4453
Entity
Organization
Contact information
Practice address
400 E RANDOLPH ST APT 3515, CHICAGO, IL 60601-7308
(312) 618-7001
Mailing address
400 E RANDOLPH ST APT 3515, CHICAGO, IL 60601-7308
(312) 618-7001
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3001799
IDPH
IL
Enumeration date
11/15/2019
Last updated
11/15/2019
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