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General NPI Number Information
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NPI Number | 1396811394
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Entity Type | Organization
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Legal Business Name | DYNACARE HOME HEALTH, INC.
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15 SPINNING WHEEL RD SUITE 426
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City | HINSDALE
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State | IL
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Zip | 60521-2914
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Country | US
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Telephone | 630-654-1641
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Fax | 630-654-1642
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Provider Business Mailing Address
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Address Line | 4800 W 129TH ST
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City | ALSIP
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State | IL
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Zip | 60803-3016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ABITURAB T. BOXWALLA
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Credential |
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Telephone | 708-560-2925
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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 | 1007277
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License Number State | IL
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