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General NPI Number Information
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NPI Number | 1568456143
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Entity Type | Organization
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Legal Business Name | EXCELLENT HOME HEALTH CARE INC
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3901 W OAKTON AVENUE
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City | SKOKIE
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State | IL
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Zip | 60076-3431
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Country | US
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Telephone | 847-674-3202
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Fax | 847-674-2719
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Provider Business Mailing Address
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Address Line | 3901 W OAKTON AVENUE
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City | SKOKIE
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State | IL
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Zip | 60076-3431
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Country | US
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Telephone | 847-674-3202
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Fax | 847-674-2719
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. FRUCTOSA O LISING
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Credential | RN BSN
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Telephone | 847-674-3202
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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 | 1010273
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License Number State | IL
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