Provider Demographics
NPI:1538304167
Name:LIFE OPTIONS HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:LIFE OPTIONS HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-628-7499
Mailing Address - Street 1:4001 W. DEVON AVE.
Mailing Address - Street 2:SUITE 409
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646
Mailing Address - Country:US
Mailing Address - Phone:773-628-7499
Mailing Address - Fax:773-647-1394
Practice Address - Street 1:4001 W. DEVON AVE
Practice Address - Street 2:SUITE 409
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646
Practice Address - Country:US
Practice Address - Phone:773-628-7499
Practice Address - Fax:773-647-1394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-11
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010864251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
148072Medicare Oscar/Certification