Healthcare Provider Details

I. General information

NPI: 1508065087
Provider Name (Legal Business Name): DEVOTED HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2007
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2720 S RIVER RD STE 4
DES PLAINES IL
60018-4109
US

IV. Provider business mailing address

1328 MAIN ST # 1A
CRETE IL
60417-2131
US

V. Phone/Fax

Practice location:
  • Phone: 847-991-3711
  • Fax: 847-991-3716
Mailing address:
  • Phone: 847-991-3711
  • Fax: 847-991-3716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1010692
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CARLOS ADRANEDA
Title or Position: PRESIDENT
Credential: LPN
Phone: 847-991-3711