=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407809379
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMPMED HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2006
-----------------------------------------------------
Last Update Date | 04/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2720 S RIVER RD STE 135
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60018-4111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-674-6796
-----------------------------------------------------
Fax | 224-534-3898
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2720 S RIVER RD STE 135
-----------------------------------------------------
City | DES PLAINES
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60018-4111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-674-6796
-----------------------------------------------------
Fax | 224-534-3898
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SALLY HUNTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 847-674-6796
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1011231
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------