Illinois Senior Services Inc

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

ILLINOIS SENIOR SERVICES INC

Practice address

2634 W Devon Ave
Chicago, IL 60659-1887

Phone

(773) 336-7632

Fax

(773) 249-1244

NPI assigned

Feb 4, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Majeed Abdul Mohammed

Title

Owner/Administrator

Phone

(773) 336-7632

Specialties & licenses 1

Addresses

Other names 1

• Illinois Senior Services Former legal business name

Electronic endpoints 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1669003083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2634 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591887",
            "telephone_number": "773-336-7632",
            "fax_number": "773-249-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591887",
            "telephone_number": "773-336-7632",
            "fax_number": "773-249-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS SENIOR SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-04",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A",
        "authorized_official_last_name": "MOHAMMED",
        "authorized_official_first_name": "MAJEED",
        "authorized_official_middle_name": "ABDUL",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "773-336-7632",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "address_1": "5875 N Lincoln Ave Ste 141",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606594617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "illinoisseniorservice@gmail.com",
            "affiliation": "N",
            "address_1": "2634 W Devon Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606591887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Illinois Senior Services",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Illinois Senior Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Homemaker in Chicago, IL
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• Homemaker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.