# LAKESHORE SENIOR SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063057800
- **Authorized official:** MR. THOMAS A VOLINI (PRESIDENT)
- **Authorized official phone:** (708) 267-4453

## Contact information

- **Practice address:** 400 E RANDOLPH ST APT 3515, CHICAGO, IL 60601-7308
- **Practice address phone:** (312) 618-7001
- **Mailing address:** 400 E RANDOLPH ST APT 3515, CHICAGO, IL 60601-7308
- **Mailing address phone:** (312) 618-7001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/15/2019
- **Last updated:** 11/15/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 3001799 | IDPH | IL |