Healthcare Provider Details

I. General information

NPI: 1508920182
Provider Name (Legal Business Name): DYNA CARE HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 S MAIN ST
ALGONQUIN IL
60102-2741
US

IV. Provider business mailing address

18454 W WEST CREEK DR
TINLEY PARK IL
60477-6273
US

V. Phone/Fax

Practice location:
  • Phone: 847-658-2220
  • Fax: 847-658-2221
Mailing address:
  • Phone: 708-560-7200
  • Fax: 708-560-7350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1007277
License Number StateIL

VIII. Authorized Official

Name: MR. ABI TURAB BOXWALLA
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 708-560-7200