Provider Demographics
NPI:1801802012
Name:CARE CENTERS HEALTH SYSTEMS LIMITED
Entity type:Organization
Organization Name:CARE CENTERS HEALTH SYSTEMS LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:YISHAI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRONER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-612-5680
Mailing Address - Street 1:200 HOWARD AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5909
Mailing Address - Country:US
Mailing Address - Phone:224-612-5662
Mailing Address - Fax:224-612-5862
Practice Address - Street 1:200 HOWARD AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-5906
Practice Address - Country:US
Practice Address - Phone:224-612-5662
Practice Address - Fax:224-612-5862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.00378332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0241503OtherANTHEM BCBS
IL363874609001Medicaid
IL01625203OtherBCBS
IN200199080AMedicaid
OH2211681Medicaid
OH2211681Medicaid