Provider Demographics
NPI:1629308689
Name:CARE SPECIALISTS, INC
Entity Type:Organization
Organization Name:CARE SPECIALISTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FERDINAND MARLO
Authorized Official - Middle Name:CAGULADA
Authorized Official - Last Name:ECHAVIA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:312-225-2501
Mailing Address - Street 1:2237 S WENTWORTH AVE
Mailing Address - Street 2:STE 304-306
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2011
Mailing Address - Country:US
Mailing Address - Phone:312-225-2501
Mailing Address - Fax:312-225-0847
Practice Address - Street 1:2237 S WENTWORTH AVE
Practice Address - Street 2:STE 304-306
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2011
Practice Address - Country:US
Practice Address - Phone:312-225-2501
Practice Address - Fax:312-225-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1954519251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1954519OtherSTATE OF ILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE