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General NPI Number Information
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NPI Number | 1083847891
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Entity Type | Organization
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Legal Business Name | CENTER OF ILLINOIS HOME HEALTHCARE, INC.
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 855 E GOLF RD STE 2147
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-5225
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Country | US
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Telephone | 847-437-0774
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Fax | 847-437-0776
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Provider Business Mailing Address
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Address Line | 855 E GOLF RD SUITE 2134
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005-5222
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Country | US
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Telephone | 847-437-0774
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIEL J GORR
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Credential |
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Telephone | 847-437-0774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1011077
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License Number State | IL
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