Organization
SENIOR HEALTH INFORMATION NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LOUISE GAINES (PRESIDENT)
(612) 306-4843
Entity
Organization
Contact information
Practice address
5757 N LINCOLN AVE STE 15, CHICAGO, IL 60659-4729
(612) 306-4843
Mailing address
5757 N LINCOLN AVE STE 15, CHICAGO, IL 60659-4729
(877) 981-6500
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
252Y00000X
Early Intervention Provider Agency
—
IL
253Z00000X
In Home Supportive Care Agency
—
—
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282J00000X
Religious Nonmedical Health Care Institution
Primary
—
IL
302F00000X
Exclusive Provider Organization
—
—
310400000X
Assisted Living Facility
—
IL
Other
Enumeration date
09/20/2017
Last updated
06/01/2021
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