Provider Demographics
NPI:1588042618
Name:CHICAGO HOME CAREGIVERS
Entity Type:Organization
Organization Name:CHICAGO HOME CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:I
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-679-0987
Mailing Address - Street 1:1263 S HIGHLAND AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1263 S HIGHLAND AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4516
Practice Address - Country:US
Practice Address - Phone:773-679-0987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0OtherHOME CARE