Healthcare Provider Details

I. General information

NPI: 1346835337
Provider Name (Legal Business Name): CAREPAKS HEALTH SERVICES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 03/02/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 SUSAN DR
NORMAL IL
61761-6142
US

IV. Provider business mailing address

209 SUSAN DR
NORMAL IL
61761-6142
US

V. Phone/Fax

Practice location:
  • Phone: 309-454-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CATHY EBO
Title or Position: DIRECTOR
Credential:
Phone: 309-454-1000