Healthcare Provider Details

I. General information

NPI: 1083771315
Provider Name (Legal Business Name): OPTUM HEALTHCARE OF ILLINOIS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 10/25/2022
Certification Date: 10/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 MCCONNOR PKWY
SCHAUMBURG IL
60173-6801
US

IV. Provider business mailing address

2100 RIVEREDGE PKWY STE 500
ATLANTA GA
30328-4676
US

V. Phone/Fax

Practice location:
  • Phone: 224-231-1070
  • Fax: 678-337-3606
Mailing address:
  • Phone: 770-767-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DARLENE RIGGINS-JONES
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 770-767-4824