Organization
FAMILY CHOICE HOME HEALTH
Active
Other names
Family Choice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LINO COSTALES JR. (AGENCY MANAGER)
(773) 774-6630
Entity
Organization
Contact information
Practice address
5933 N MILWAUKEE AVENUE, CHICAGO, IL 60646
(773) 774-6630
(773) 774-1470
Mailing address
5933 N MILWAUKEE AVE, CHICAGO, IL 60646-5419
(773) 774-6630
(773) 774-1470
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D1076797
CLIA ID NUMBER
IL
Enumeration date
03/13/2013
Last updated
11/22/2016
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