Provider Demographics
NPI:1316499023
Name:ECHRYSALIS, INC.
Entity type:Organization
Organization Name:ECHRYSALIS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:WILCOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-457-2399
Mailing Address - Street 1:75 EXECUTIVE DRIVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504
Mailing Address - Country:US
Mailing Address - Phone:331-457-2399
Mailing Address - Fax:331-301-5170
Practice Address - Street 1:600 S WASHINGTON ST STE 304
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6667
Practice Address - Country:US
Practice Address - Phone:331-212-5318
Practice Address - Fax:331-301-5170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-28
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health