Healthcare Provider Details

I. General information

NPI: 1194808402
Provider Name (Legal Business Name): FOUR SEASONS HOME HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 OAKTON ST
MORTON GROVE IL
60053-2717
US

IV. Provider business mailing address

6050 OAKTON ST
MORTON GROVE IL
60053-2717
US

V. Phone/Fax

Practice location:
  • Phone: 847-966-1616
  • Fax:
Mailing address:
  • Phone: 847-966-1616
  • Fax: 847-966-1689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number041335023
License Number StateIL

VIII. Authorized Official

Name: MR. PHILLIP SHLIMON
Title or Position: ADMINISTRATOR
Credential:
Phone: 847-966-1616