Provider Demographics
NPI:1093878431
Name:FIRST CHOICE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-516-1240
Mailing Address - Street 1:221 E LAKE ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2888
Mailing Address - Country:US
Mailing Address - Phone:630-516-1240
Mailing Address - Fax:630-516-1243
Practice Address - Street 1:221 E LAKE ST
Practice Address - Street 2:SUITE 207
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2888
Practice Address - Country:US
Practice Address - Phone:630-516-1240
Practice Address - Fax:630-516-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147884251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147884Medicare ID - Type Unspecified