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General NPI Number Information
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NPI Number | 1194948976
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Entity Type | Organization
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Legal Business Name | IMMANUEL HOME CARE SERVICES, INC.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 712 E 47TH ST SUITE 301E
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City | CHICAGO
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State | IL
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Zip | 60653-4202
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Country | US
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Telephone | 773-285-2227
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Fax | 773-285-3033
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Provider Business Mailing Address
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Address Line | 712 E 47TH ST SUITE 301E
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City | CHICAGO
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State | IL
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Zip | 60653-4202
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Country | US
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Telephone | 773-285-2227
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Fax | 773-285-3033
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. IRENE EDWARDS EDWARDS
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Credential | RN
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Telephone | 815-577-7192
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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 |
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License Number State | IL
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