Provider Demographics
NPI:1780938019
Name:ASSYRIAN UNIVERSAL ALLIANCE FOUNDATION
Entity type:Organization
Organization Name:ASSYRIAN UNIVERSAL ALLIANCE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:DAKOF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-863-3569
Mailing Address - Street 1:4343 W. TOUHY AVE.
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1908
Mailing Address - Country:US
Mailing Address - Phone:773-274-9262
Mailing Address - Fax:224-251-7620
Practice Address - Street 1:4343 W. TOUHY AVE.
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1908
Practice Address - Country:US
Practice Address - Phone:773-274-9262
Practice Address - Fax:224-251-7620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty