Healthcare Provider Details

I. General information

NPI: 1356664650
Provider Name (Legal Business Name): SIENNA HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 S RICHARD CT
VERNON HILLS IL
60061-2657
US

IV. Provider business mailing address

348 S RICHARD CT
VERNON HILLS IL
60061-2657
US

V. Phone/Fax

Practice location:
  • Phone: 847-680-1992
  • Fax: 866-680-2199
Mailing address:
  • Phone: 847-680-1992
  • Fax: 866-680-2199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number4000294
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3000602
License Number StateIL

VIII. Authorized Official

Name: LORA MANTELMAN
Title or Position: PRESIDENT
Credential: RN
Phone: 847-680-1992