Healthcare Provider Details

I. General information

NPI: 1639015902
Provider Name (Legal Business Name): JJJ HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

813 TEK DR
CRYSTAL LAKE IL
60014-8172
US

IV. Provider business mailing address

813 TEK DR
CRYSTAL LAKE IL
60014-8172
US

V. Phone/Fax

Practice location:
  • Phone: 630-672-5280
  • Fax: 630-672-5281
Mailing address:
  • Phone: 630-672-5280
  • Fax: 630-672-5281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RACHELLE DAVID
Title or Position: NURSE ADMINISTRATOR
Credential:
Phone: 630-672-5280