Provider Demographics
NPI:1821153057
Name:GENTLEPRO HOSPICE SERVICES CORP
Entity Type:Organization
Organization Name:GENTLEPRO HOSPICE SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUERUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-228-9481
Mailing Address - Street 1:2060 E ALGONQUIN RD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4162
Mailing Address - Country:US
Mailing Address - Phone:847-228-9481
Mailing Address - Fax:847-228-9486
Practice Address - Street 1:2060 E ALGONQUIN RD
Practice Address - Street 2:SUITE 701
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4162
Practice Address - Country:US
Practice Address - Phone:847-228-9481
Practice Address - Fax:847-228-9486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002301251G00000X
251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based