Organization
SHOTFAIRY.COM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. COLLEEN HANLON (DIRECTOR OF HUMAN RESOURCES)
(312) 328-7468
Entity
Organization
Contact information
Practice address
3135 S GILES AVE, CHICAGO, IL 60616-3937
(312) 328-7468
Mailing address
PO BOX 166593, CHICAGO, IL 60616-6593
(312) 328-7468
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
4000255
IL
Other
Enumeration date
09/08/2009
Last updated
09/08/2009
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