Healthcare Provider Details

I. General information

NPI: 1285198523
Provider Name (Legal Business Name): SUGAR HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HOLIDAY PLAZA DR
MATTESON IL
60443-2241
US

IV. Provider business mailing address

19319 TRAMORE LN
MOKENA IL
60448-8613
US

V. Phone/Fax

Practice location:
  • Phone: 312-924-1831
  • Fax: 312-924-1832
Mailing address:
  • Phone: 312-924-1831
  • Fax: 312-924-1832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ERICA C ROBINSON
Title or Position: MANAGER
Credential:
Phone: 773-828-3093