Healthcare Provider Details

I. General information

NPI: 1144948548
Provider Name (Legal Business Name): VISION HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 N HIAWATHA AVE STE 305
CHICAGO IL
60646-4335
US

IV. Provider business mailing address

6200 N HIAWATHA AVE STE 305
CHICAGO IL
60646-4335
US

V. Phone/Fax

Practice location:
  • Phone: 773-312-2385
  • Fax:
Mailing address:
  • Phone: 773-312-2385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. SAMIT ANSARI
Title or Position: PRESIDENT
Credential:
Phone: 773-312-2385