Provider Demographics
NPI:1871003335
Name:CENTER FOR SENIORS
Entity Type:Organization
Organization Name:CENTER FOR SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:INCHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-478-1245
Mailing Address - Street 1:8900 CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-7203
Mailing Address - Country:US
Mailing Address - Phone:847-465-9999
Mailing Address - Fax:847-465-9949
Practice Address - Street 1:8900 CAPITOL DR
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-7203
Practice Address - Country:US
Practice Address - Phone:847-465-9999
Practice Address - Fax:847-465-9949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILADS1813010261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care