Provider Demographics
NPI:1558769091
Name:CARING HANDS CILA OF ILLINOIS INC
Entity Type:Organization
Organization Name:CARING HANDS CILA OF ILLINOIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHUMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-954-4476
Mailing Address - Street 1:22113 GOVERNORS HWY
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1249
Mailing Address - Country:US
Mailing Address - Phone:773-954-4476
Mailing Address - Fax:
Practice Address - Street 1:14475 JOHN HUMPHREY DR
Practice Address - Street 2:SUITE 130
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6205
Practice Address - Country:US
Practice Address - Phone:773-954-4476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL201400013C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid