Provider Demographics
NPI:1861680092
Name:CARESERVICES OF ILLINOIS LLC
Entity type:Organization
Organization Name:CARESERVICES OF ILLINOIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAXINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOCHHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-244-3672
Mailing Address - Street 1:2400 HIGH RIDGE RD
Mailing Address - Street 2:SUITE 101 AND 103
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8725
Mailing Address - Country:US
Mailing Address - Phone:561-244-0220
Mailing Address - Fax:561-244-0221
Practice Address - Street 1:1100 W CENTRAL RD
Practice Address - Street 2:404
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2402
Practice Address - Country:US
Practice Address - Phone:847-506-3100
Practice Address - Fax:847-506-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL216516363A00000X, 363LP2300X
IL101727251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherEIN#
IL147635Medicare Oscar/Certification
IL216516Medicare PIN