Healthcare Provider Details

I. General information

NPI: 1972834166
Provider Name (Legal Business Name): EHS HOME HEALTH CARE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2010
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N HERSHEY RD SUITE C
BLOOMINGTON IL
61704-3576
US

IV. Provider business mailing address

2311 W 22ND ST SUITE 300
OAK BROOK IL
60523-1225
US

V. Phone/Fax

Practice location:
  • Phone: 309-888-0930
  • Fax: 309-268-5960
Mailing address:
  • Phone: 630-572-1232
  • Fax: 630-368-5912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1001932
License Number StateIL

VIII. Authorized Official

Name: TONIA YOLANDA BURRELL PACE
Title or Position: DIRECTOR, PATIENT ACCOUNTS
Credential:
Phone: 630-368-6570