Organization
1ADEM HOMECARE ILLINOIS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATISHA LAKE (OWNER/TREASURER)
(773) 640-9020
Entity
Organization
Contact information
Practice address
5504 S MICHIGAN AVE APT 316, CHICAGO, IL 60637-1794
(773) 640-9020
Mailing address
5504 S MICHIGAN AVE APT 316, CHICAGO, IL 60637-1794
(773) 640-9020
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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