Provider Demographics
NPI:1134768930
Name:HEART AND SOUL INC
Entity type:Organization
Organization Name:HEART AND SOUL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRESANTHAKES
Authorized Official - Suffix:
Authorized Official - Credentials:CSCM
Authorized Official - Phone:773-627-6091
Mailing Address - Street 1:1645 BIRCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-3003
Mailing Address - Country:US
Mailing Address - Phone:224-616-7405
Mailing Address - Fax:
Practice Address - Street 1:1645 BIRCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-3003
Practice Address - Country:US
Practice Address - Phone:224-616-7405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-27
Last Update Date:2019-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care