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General NPI Number Information
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NPI Number | 1417188426
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Entity Type | Organization
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Legal Business Name | MID AMERICA HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 08/07/2009
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 1919 S HIGHLAND AVE STE 137
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City | LOMBARD
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State | IL
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Zip | 60148-6153
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Country | US
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Telephone | 630-519-4099
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Fax | 630-519-3186
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Provider Business Mailing Address
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Address Line | 1919 S HIGHLAND AVE STE 137
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City | LOMBARD
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State | IL
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Zip | 60148-6153
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Country | US
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Telephone | 630-519-4099
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Fax | 630-519-3186
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. TYRONE ROMERO
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Credential |
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Telephone | 630-519-4099
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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 | 1011076
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License Number State | IL
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