Provider Demographics
NPI:1760136378
Name:CHERUB CARES
Entity Type:Organization
Organization Name:CHERUB CARES
Other - Org Name:HOMEWATCH CAREGIVERS LINCOLNWOOD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERUVATHOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-567-0578
Mailing Address - Street 1:4207 W JARVIS AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1905
Mailing Address - Country:US
Mailing Address - Phone:847-567-0578
Mailing Address - Fax:
Practice Address - Street 1:4747 W PETERSON AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5770
Practice Address - Country:US
Practice Address - Phone:773-647-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care