Provider Demographics
NPI:1063105187
Name:NORTH SHORE SENIOR CARE LLC
Entity type:Organization
Organization Name:NORTH SHORE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NOVY
Authorized Official - Suffix:
Authorized Official - Credentials:CPG, MA, MS
Authorized Official - Phone:847-324-9450
Mailing Address - Street 1:5550 TOUHY AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3254
Mailing Address - Country:US
Mailing Address - Phone:847-324-9450
Mailing Address - Fax:847-999-3663
Practice Address - Street 1:5550 TOUHY AVE STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3254
Practice Address - Country:US
Practice Address - Phone:847-324-9450
Practice Address - Fax:847-999-3663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMADA SENIOR CARE FRANCHISOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty