Provider Demographics
NPI:1093102600
Name:CHARTWELL STAFFING SERVICES,INC
Entity Type:Organization
Organization Name:CHARTWELL STAFFING SERVICES,INC
Other - Org Name:CHARTWELL NURISNG SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISOSTOMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-656-5787
Mailing Address - Street 1:229 1ST AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:ROCK FALLS
Mailing Address - State:IL
Mailing Address - Zip Code:61071-5107
Mailing Address - Country:US
Mailing Address - Phone:815-564-0977
Mailing Address - Fax:815-564-0983
Practice Address - Street 1:229 1ST AVE STE 2
Practice Address - Street 2:
Practice Address - City:ROCK FALLS
Practice Address - State:IL
Practice Address - Zip Code:61071-5107
Practice Address - Country:US
Practice Address - Phone:815-564-0977
Practice Address - Fax:815-564-0983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4000497251E00000X
IL3001298251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health