Provider Demographics
NPI:1730500315
Name:ILLINOIS CARE AND TRAINING INC.
Entity Type:Organization
Organization Name:ILLINOIS CARE AND TRAINING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:N,
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-271-4110
Mailing Address - Street 1:4554 N BROADWAY ST STE 314
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5621
Mailing Address - Country:US
Mailing Address - Phone:773-271-4110
Mailing Address - Fax:773-784-5154
Practice Address - Street 1:4554 N BROADWAY ST STE 314
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5621
Practice Address - Country:US
Practice Address - Phone:773-271-4110
Practice Address - Fax:773-784-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care