Healthcare Provider Details

I. General information

NPI: 1609825678
Provider Name (Legal Business Name): COMMUNITY ALLIANCE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 05/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MERCHANTS PLAZA SUITE 202
OSWEGO IL
60543-9453
US

IV. Provider business mailing address

ONE MERCHANTS PLAZA SUITE 202
OSWEGO IL
60543-9453
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-7851
  • Fax: 630-933-7852
Mailing address:
  • Phone: 630-933-7851
  • Fax: 630-933-7852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1010207
License Number StateIL

VIII. Authorized Official

Name: MRS. MARLA MARIE HUSCH
Title or Position: DIRECTOR, OPERATIONS
Credential: RPH
Phone: 630-665-7000