Provider Demographics
NPI:1679959555
Name:AGING CARE CONNECTIONS
Entity Type:Organization
Organization Name:AGING CARE CONNECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERSCHELDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-354-1323
Mailing Address - Street 1:111 W HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2336
Mailing Address - Country:US
Mailing Address - Phone:708-354-1323
Mailing Address - Fax:708-354-0282
Practice Address - Street 1:111 W HARRIS AVE
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2336
Practice Address - Country:US
Practice Address - Phone:708-354-1323
Practice Address - Fax:708-354-0282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
IL251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251V00000XAgenciesVoluntary or Charitable