Provider Demographics
NPI:1497212351
Name:COMPANION SERVICES OF AMERICA
Entity Type:Organization
Organization Name:COMPANION SERVICES OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:847-948-0860
Mailing Address - Street 1:420 LAKE COOK RD STE 112
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4914
Mailing Address - Country:US
Mailing Address - Phone:847-948-0860
Mailing Address - Fax:847-948-9819
Practice Address - Street 1:420 LAKE COOK RD STE 112
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4914
Practice Address - Country:US
Practice Address - Phone:847-948-0860
Practice Address - Fax:847-948-9819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3000559OtherHOME SERVICE AGENCY
IL4000521OtherHOME NURSING AGENCY