Healthcare Provider Details

I. General information

NPI: 1639292824
Provider Name (Legal Business Name): INTEGRATED HOMECARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3902 W RIVERSIDE BLVD
ROCKFORD IL
61101-9507
US

IV. Provider business mailing address

5027 HARRISON AVE
ROCKFORD IL
61108-8010
US

V. Phone/Fax

Practice location:
  • Phone: 815-962-0202
  • Fax: 815-963-2801
Mailing address:
  • Phone: 815-227-0202
  • Fax: 815-227-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number StateIL

VIII. Authorized Official

Name: MS. PAT DIGIOVANNI
Title or Position: PRESIDENT
Credential: RRT
Phone: 815-227-0202