Provider Demographics
NPI:1801899406
Name:CARE COLLABORATIVE HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:CARE COLLABORATIVE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOLSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:312-949-1010
Mailing Address - Street 1:439 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4000
Mailing Address - Country:US
Mailing Address - Phone:312-949-1010
Mailing Address - Fax:312-949-9145
Practice Address - Street 1:439 E 31ST ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4000
Practice Address - Country:US
Practice Address - Phone:312-949-1010
Practice Address - Fax:312-949-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL1010250251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147743Medicare Oscar/Certification