Organization
STATE OF ILLINOIS DEPARTMENT OF HUMAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATASHA CRAIG (CNA / HOME HEALTH AID)
(312) 513-4566
Entity
Organization
Contact information
Practice address
10724 S INDIANA AVE, CHICAGO, IL 60628-3615
(312) 513-4566
Mailing address
10724 S INDIANA AVE, CHICAGO, IL 60628-3615
(312) 513-4566
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
0971
IL
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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