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General NPI Number Information
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NPI Number | 1629259197
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Entity Type | Organization
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Legal Business Name | STATE HOME HEALTH AGENCY, LTD.
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 11/22/2010
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Provider Practice Location Address
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Address Line | 17W727 BUTTERFIELD RD SUITE F & G
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4278
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Country | US
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Telephone | 630-320-1400
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Fax | 630-320-1401
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Provider Business Mailing Address
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Address Line | 17W727 BUTTERFIELD RD SUITE F & G
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City | OAKBROOK TERRACE
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State | IL
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Zip | 60181-4278
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Country | US
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Telephone | 630-320-1400
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Fax | 630-320-1401
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. TASNEEM JAMAL
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Credential |
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Telephone | 630-320-1400
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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 |
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License Number State |
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