Healthcare Provider Details
I. General information
NPI: 1760011258
Provider Name (Legal Business Name): UNITED VISION HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1620 PEBBLEWOOD LN STE 296
NAPERVILLE IL
60563-8357
US
IV. Provider business mailing address
1620 PEBBLEWOOD LN STE 296
NAPERVILLE IL
60563-8357
US
V. Phone/Fax
- Phone: 630-449-2186
- Fax:
- Phone: 630-449-2186
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NSO
NSO
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 331-431-9864