1821323866 NPI number — CONGREGATION OF THE DAUGHTERS OF DIVINE LOVE

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821323866 NPI number — CONGREGATION OF THE DAUGHTERS OF DIVINE LOVE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONGREGATION OF THE DAUGHTERS OF DIVINE LOVE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DAUGHTERS OF DIVINE LOVE HOME HEALTH CARE AGENCY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821323866
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2653 N HARLEM AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60707-1629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-385-6670
Provider Business Mailing Address Fax Number:
773-385-6680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2653 N HARLEM AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60707-1629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-385-6670
Provider Business Practice Location Address Fax Number:
773-385-6680
Provider Enumeration Date:
10/08/2009

Additional Information

Authorized Official

Authorized Official Last Name:
AMAEFULE
Authorized Official First Name:
EUCHARIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
773-385-6670

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1011222 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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