Provider Demographics
NPI:1902125594
Name:CREATIVE HEALTHCARE PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:CREATIVE HEALTHCARE PROFESSIONALS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-789-2514
Mailing Address - Street 1:8150 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-2605
Mailing Address - Country:US
Mailing Address - Phone:773-789-2514
Mailing Address - Fax:773-789-2513
Practice Address - Street 1:8150 S KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-2605
Practice Address - Country:US
Practice Address - Phone:773-789-2514
Practice Address - Fax:773-789-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-22
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health