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MOBILE CARE FOUNDATION NPI 1265502728


NPI Information

NPI: 1265502728
Provider Name: MOBILE CARE FOUNDATION

Doing Business As: MOBILE CARE CHICAGO

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 14D2168344

Address:
239 W ROOT ST
CHICAGO, IL
ZIP 60609
Phone: (773) 254-4030
Get Directions

MOBILE CARE FOUNDATION is a specialist in Chicago, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MOBILE CARE FOUNDATION NPI is 1265502728. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mobile Care Chicago.

The provider's business location address is:

239 W ROOT ST
CHICAGO, IL
ZIP 60609-848
Phone: (773) 254-4030

The provider's authorized official is Rita Castaneda .
The authorized official title is Office Manager and has the following contact phone number (773) 254-4030.

The CLIA number assigned to this NPI record is 14D2168344 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/9/2006 and was last updated on 2/15/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist036090394ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036090394MEDICAIDILLINOIS
201635798OTHERILLINOISBCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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