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General NPI Number Information
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NPI Number | 1306961123
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Entity Type | Organization
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Legal Business Name | PEARL HEALTH CARE SERVICES, INC.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 04/18/2019
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Provider Practice Location Address
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Address Line | 136 W LAKE ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1020
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Country | US
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Telephone | 630-307-9617
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Fax | 630-307-9457
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Provider Business Mailing Address
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Address Line | 136 W LAKE ST
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1020
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Country | US
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Telephone | 630-307-9617
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Fax | 630-307-9457
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | WILLIAM LOWE
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Credential |
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Telephone | 773-596-2300
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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 | 1009612
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License Number State | IL
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