Provider Demographics
NPI:1073999876
Name:CHICAGOLAND HOMECARE, INC
Entity Type:Organization
Organization Name:CHICAGOLAND HOMECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVERIAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-749-4542
Mailing Address - Street 1:906 W NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5345
Mailing Address - Country:US
Mailing Address - Phone:847-749-4542
Mailing Address - Fax:847-378-4542
Practice Address - Street 1:906 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5345
Practice Address - Country:US
Practice Address - Phone:847-749-4542
Practice Address - Fax:847-378-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000723253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care