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General NPI Number Information
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NPI Number | 1144413048
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Entity Type | Organization
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Legal Business Name | MEDSERVE HOME HEALTHCARE, INC
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 4001 W DEVON AVE SUITE 402
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City | CHICAGO
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State | IL
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Zip | 60646-4539
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Country | US
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Telephone | 773-282-6721
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Fax | 866-337-8961
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Provider Business Mailing Address
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Address Line | 4001 W DEVON AVE SUITE 402
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City | CHICAGO
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State | IL
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Zip | 60646-4539
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Country | US
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Telephone | 773-282-6721
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Fax | 866-337-8961
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Authorized Official
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Title or Position | ADMINISTRATOR / DON
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Name | CHRISTINE CHERYL GASPAR
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Credential | RN
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Telephone | 773-282-6721
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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 | 1010753
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License Number State | IL
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