Provider Demographics
NPI:1942534466
Name:KAALYN HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:KAALYN HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ONWER
Authorized Official - Prefix:
Authorized Official - First Name:SHELEE
Authorized Official - Middle Name:ANNTIONTTE
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-398-7765
Mailing Address - Street 1:6333 S ADA ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-2914
Mailing Address - Country:US
Mailing Address - Phone:773-398-7765
Mailing Address - Fax:
Practice Address - Street 1:6333 S ADA ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60636-2914
Practice Address - Country:US
Practice Address - Phone:773-398-7765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1998525253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care