Provider Demographics
NPI:1093775363
Name:GERICARE, LTD.
Entity Type:Organization
Organization Name:GERICARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIONISIO-BUNIAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-299-7888
Mailing Address - Street 1:1600 W DEMPSTER ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1171
Mailing Address - Country:US
Mailing Address - Phone:847-299-7888
Mailing Address - Fax:847-299-7844
Practice Address - Street 1:1600 W DEMPSTER ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1109
Practice Address - Country:US
Practice Address - Phone:847-299-7888
Practice Address - Fax:847-299-7844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK19961Medicare ID - Type UnspecifiedCHIN
IL213070Medicare ID - Type UnspecifiedWESTON
ILH29087Medicare UPIN
ILF31121Medicare UPIN
ILC40757Medicare UPIN
ILL78525Medicare ID - Type UnspecifiedKATSOYANNIS
ILK10639Medicare ID - Type UnspecifiedBAZAN
ILG54275Medicare UPIN
ILL78526Medicare ID - Type UnspecifiedPODGERS
ILS18937Medicare UPIN