Healthcare Provider Details

I. General information

NPI: 1265724066
Provider Name (Legal Business Name): GOODHOPE HEALTHCARE AND HOME HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2011
Last Update Date: 02/16/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3631 MUNICIPAL DR
MCHENRY IL
60050-5434
US

IV. Provider business mailing address

3631 MUNICIPAL DR
MCHENRY IL
60050-5434
US

V. Phone/Fax

Practice location:
  • Phone: 815-788-7190
  • Fax: 800-884-1732
Mailing address:
  • Phone: 815-788-7190
  • Fax: 800-884-1732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1011393
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number4000326
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3000707
License Number StateIL
# 9
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. CHIMATARA EBIRIM
Title or Position: PRESIDENT
Credential: RN, BSN
Phone: 815-788-7190