Healthcare Provider Details

I. General information

NPI: 1891196234
Provider Name (Legal Business Name): TEE HOME CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2014
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16310 S LINCOLN HWY UNIT 106
PLAINFIELD IL
60586-9006
US

IV. Provider business mailing address

16310 S LINCOLN HWY UNIT 106
PLAINFIELD IL
60586-9006
US

V. Phone/Fax

Practice location:
  • Phone: 815-609-1122
  • Fax: 815-609-0076
Mailing address:
  • Phone: 815-609-1122
  • Fax: 815-609-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. BRENDA L ERICSON
Title or Position: OWNER/AGENCY MANAGER
Credential:
Phone: 815-609-1122