Provider Demographics
NPI:1427512250
Name:VISITING CARE PROVIDERS LLC
Entity type:Organization
Organization Name:VISITING CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NP
Authorized Official - Prefix:
Authorized Official - First Name:KHADRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALJAZI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:312-610-2875
Mailing Address - Street 1:3505 N PONTIAC AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2849
Mailing Address - Country:US
Mailing Address - Phone:312-610-2875
Mailing Address - Fax:
Practice Address - Street 1:3505 N PONTIAC AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-2849
Practice Address - Country:US
Practice Address - Phone:312-610-2875
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty