Organization
PERSONALLY PAM LTD
Active
Other names
PERSONAL NURSING SERVICE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL ALLEN TROST (PRESIDENT)
(773) 233-3337
Entity
Organization
Contact information
Practice address
10436 S KEDZIE AVE, CHICAGO, IL 60655-2018
(773) 233-3337
(773) 233-5630
Mailing address
10436 S KEDZIE AVE, CHICAGO, IL 60655-2018
(773) 233-3337
(773) 233-5630
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1002666
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9806
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/15/2006
Last updated
08/22/2020
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