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General NPI Number Information
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NPI Number | 1669521654
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Entity Type | Organization
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Legal Business Name | MIDWEST PEARL HOME HEALTHCARE INC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1925 N HARLEM AVE SUITE 101
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City | CHICAGO
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State | IL
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Zip | 60707-3743
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Country | US
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Telephone | 773-237-2655
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Fax | 773-237-2717
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Provider Business Mailing Address
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Address Line | 1925 N HARLEM AVE SUITE 108
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City | CHICAGO
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State | IL
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Zip | 60707-3743
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Country | US
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Telephone | 773-237-2655
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Fax | 773-237-2717
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MS. NELVA DURAN REYES
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Credential |
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Telephone | 773-237-2655
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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 | IL1010485
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License Number State | IL
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