Provider Demographics
NPI:1265719694
Name:HELPSOURCE OF NORTH SHORE DBA COMFORT KEEPERS
Entity type:Organization
Organization Name:HELPSOURCE OF NORTH SHORE DBA COMFORT KEEPERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOFIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-215-8550
Mailing Address - Street 1:310 N WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-2924
Mailing Address - Country:US
Mailing Address - Phone:847-215-8550
Mailing Address - Fax:847-215-7941
Practice Address - Street 1:310 N WOLF RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-2924
Practice Address - Country:US
Practice Address - Phone:847-215-8550
Practice Address - Fax:847-215-7941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CK FRANCHISING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILHSA 3000105253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care