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Organization
WILMETTE ELEVATED INC
Active
Organization
WILMETTE ELEVATED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSEY RAZDOLGIN (PRESIDENT)
(305) 205-7768
Entity
Organization
Contact information
Practice address
1511 W ALBION AVE APT 3, CHICAGO, IL 60626-6651
(305) 205-7768
Mailing address
1350 N LAKE SHORE DR APT 1302, CHICAGO, IL 60610-5137
(305) 205-7768
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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