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General NPI Number Information
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NPI Number | 1295697209
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Entity Type | Organization
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Legal Business Name | ITARA42 HOME CARE AGENCY
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Dates
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Enumeration Date | 11/27/2025
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 25 E 16TH ST
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-3410
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Country | US
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Telephone | 773-999-5051
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Fax | 708-856-0070
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Provider Business Mailing Address
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Address Line | 25 E 16TH ST
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-3410
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Country | US
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Telephone | 773-999-5051
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Fax | 708-856-0070
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Authorized Official
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Title or Position | MANAGER
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Name | DON DAVIS
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Credential |
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Telephone | 773-999-5051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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