Healthcare Provider Details

I. General information

NPI: 1659356483
Provider Name (Legal Business Name): INDEPENDENCE PLUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 JORIE BLVD STE 100
OAK BROOK IL
60523-2252
US

IV. Provider business mailing address

800 JORIE BLVD STE 100
OAK BROOK IL
60523-2252
US

V. Phone/Fax

Practice location:
  • Phone: 708-366-4500
  • Fax: 708-366-4553
Mailing address:
  • Phone: 800-366-7696
  • Fax: 630-954-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1004472
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. DANILO COITE
Title or Position: CEO
Credential:
Phone: 800-366-7696