Provider Demographics
NPI:1710421797
Name:PIGEON (HOSPICE, PALLATIVE, WOUND) SERVICES
Entity Type:Organization
Organization Name:PIGEON (HOSPICE, PALLATIVE, WOUND) SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-293-7898
Mailing Address - Street 1:3300 W PETERSON AVE STE H
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3509
Mailing Address - Country:US
Mailing Address - Phone:773-293-7898
Mailing Address - Fax:
Practice Address - Street 1:3300 W PETERSON AVE STE H
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3509
Practice Address - Country:US
Practice Address - Phone:773-293-7898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-11
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2003137251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based