OrganizationActive
South Lake Medical Services, Ltd
NPI 1407023849 · Adult Day Care Clinic/Center · Chicago, IL
Provider details
- NPI number
- 1407023849
- Entity type
- Organization
- Primary specialty
- Adult Day Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Maria Thachenkery, President(773) 375-1900
- License
- 036049708 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2621 E 75th St
Chicago, IL 60649-3705
Phone: (773) 375-1900
Fax: (773) 375-8279
Approximate (ZIP-level) locationGet directions
Mailing address
2621 E 75th St
Chicago, IL 60649-3705
Registry dates
- Enumerated
- 2008-05-14
- Last updated
- 2008-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.