Provider Demographics
NPI:1700357365
Name:NORTH SHORE COMPASSIONATE CARE, LLC
Entity Type:Organization
Organization Name:NORTH SHORE COMPASSIONATE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GLICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-922-6469
Mailing Address - Street 1:1510 OLD DEERFIELD RD STE 222
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3072
Mailing Address - Country:US
Mailing Address - Phone:847-922-6469
Mailing Address - Fax:
Practice Address - Street 1:1510 OLD DEERFIELD RD STE 222
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3072
Practice Address - Country:US
Practice Address - Phone:847-922-6469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care