Healthcare Provider Details

I. General information

NPI: 1710128418
Provider Name (Legal Business Name): GOLD COAST HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20200 GOVERNORS DR STE 204
OLYMPIA FIELDS IL
60461-1056
US

IV. Provider business mailing address

5291 PROVIDENCE DR
MATTESON IL
60443-1188
US

V. Phone/Fax

Practice location:
  • Phone: 708-991-7126
  • Fax:
Mailing address:
  • Phone: 312-315-1934
  • Fax: 312-229-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. REUBEN CUDJOE HADZIDE
Title or Position: ADMINISTRATOR/PRESIDENT
Credential: MR.
Phone: 312-315-1934