Provider Demographics
NPI:1083020143
Name:NORTH SHORE HEALTHCARE, INC.
Entity Type:Organization
Organization Name:NORTH SHORE HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-886-0473
Mailing Address - Street 1:9944 S ROBERTS RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1555
Mailing Address - Country:US
Mailing Address - Phone:708-658-6545
Mailing Address - Fax:708-658-6715
Practice Address - Street 1:8755 TRUMBULL AVE
Practice Address - Street 2:SECOND 2ND FLOOR
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-213-0483
Practice Address - Fax:847-213-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-09
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-211658251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health