| Chinese American Service League, Inc. | |
|
2141 S Tan Ct Chicago IL 60616-1998 | |
| (312) 791-0418 | |
| (312) 791-0509 |
| Full Name | Chinese American Service League, Inc. |
|---|---|
| Speciality | Homemaker |
| Location | 2141 S Tan Ct, Chicago, Illinois |
| Authorized Official Name and Position | Jered Gregory Pruitt (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 3123286606 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chinese American Service League, Inc. 2141 S Tan Ct Chicago IL 60616-1998 Ph: (312) 791-0418 | Chinese American Service League, Inc. 2141 S Tan Ct Chicago IL 60616-1998 Ph: (312) 791-0418 |
| NPI Number | 1902161490 |
|---|---|
| Provider Enumeration Date | 07/10/2012 |
| Last Update Date | 12/07/2023 |
| Certification Date | 12/07/2023 |
| Medicare PECOS PAC ID | 1951717933 |
|---|---|
| Medicare Enrollment ID | O20210317001952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902161490 | NPI | - | NPPES |
| Provider Name | Jeannie Tsui |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578937991 PECOS PAC ID: 8921414905 Enrollment ID: I20210317002085 |
| Provider Name | Winnie S Lam |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790431153 PECOS PAC ID: 1951779024 Enrollment ID: I20221121001837 |
| Provider Name | Chunping Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558135004 PECOS PAC ID: 6305294869 Enrollment ID: I20240315003457 |
| Provider Name | Adriana Padilla |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730937731 PECOS PAC ID: 7012459720 Enrollment ID: I20240610003108 |
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