Healthcare Provider Details

I. General information

NPI: 1902863061
Provider Name (Legal Business Name): GOLDEN HEART HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 09/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 W HIGGINS RD SUITE 340
ROSEMONT IL
60018-3707
US

IV. Provider business mailing address

10700 W HIGGINS RD SUITE 340
ROSEMONT IL
60018-3707
US

V. Phone/Fax

Practice location:
  • Phone: 847-759-8970
  • Fax: 847-759-8975
Mailing address:
  • Phone: 847-759-8970
  • Fax: 847-759-8975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberIL1010169
License Number StateIL

VIII. Authorized Official

Name: MR. JESS LOMIBAO
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 847-759-8970