Provider Demographics
NPI:1558040154
Name:UNITY HOSPICE OF GREATER ST LOUIS LLC
Entity Type:Organization
Organization Name:UNITY HOSPICE OF GREATER ST LOUIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ELI
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-982-1800
Mailing Address - Street 1:4101 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2753
Mailing Address - Country:US
Mailing Address - Phone:847-982-1800
Mailing Address - Fax:
Practice Address - Street 1:1604 EASTPORT PLAZA DR STE 102
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62234-6133
Practice Address - Country:US
Practice Address - Phone:847-982-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty