Provider Demographics
NPI:1427412436
Name:YOUR CHOICE HOMECARE, INC.
Entity Type:Organization
Organization Name:YOUR CHOICE HOMECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:N
Authorized Official - Middle Name:
Authorized Official - Last Name:MINICILLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-953-1113
Mailing Address - Street 1:332 S MICHIGAN AVE
Mailing Address - Street 2:SUITE 1032-Y43
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604
Mailing Address - Country:US
Mailing Address - Phone:312-953-1113
Mailing Address - Fax:
Practice Address - Street 1:332 S. MICHIGAN AVE.
Practice Address - Street 2:SUITE 1032-Y43
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60604
Practice Address - Country:US
Practice Address - Phone:312-953-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health