Individual
MISS CAPUCINE CROWDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA,HHA,PCA
Contact information
Practice address
1307 W 110TH ST, CHICAGO, IL 60643-3613
(312) 535-1602
Mailing address
1307 W 110TH ST, CHICAGO, IL 60643-3613
(312) 535-1602
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
NA
—
374U00000X
Home Health Aide
NA
IL
376K00000X
Nurse's Aide
Primary
NA
IL
376K00000X
Nurse's Aide
NA0037871
CO
Other
Enumeration date
01/05/2023
Last updated
01/05/2023
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