Provider Demographics
NPI:1760831945
Name:NUCARE INC
Entity Type:Organization
Organization Name:NUCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EX. DIR.
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-922-2111
Mailing Address - Street 1:3649 W 183RD ST
Mailing Address - Street 2:STE135
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2400
Mailing Address - Country:US
Mailing Address - Phone:708-922-2111
Mailing Address - Fax:708-922-2112
Practice Address - Street 1:18118 ORLEANS DR
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2242
Practice Address - Country:US
Practice Address - Phone:708-647-0311
Practice Address - Fax:708-647-0308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL09C006320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities