Healthcare Provider Details

I. General information

NPI: 1609046242
Provider Name (Legal Business Name): PREMIER POINT HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 N SHERIDAN RD
CHICAGO IL
60640-5021
US

IV. Provider business mailing address

4701 N SHERIDAN RD
CHICAGO IL
60640-5021
US

V. Phone/Fax

Practice location:
  • Phone: 773-275-8390
  • Fax: 773-275-8395
Mailing address:
  • Phone: 773-275-8390
  • Fax: 773-275-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1010827
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. LANRE A. SHOMADE
Title or Position: PRESIDENT
Credential: MBA
Phone: 773-275-8390