=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861717001
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADDUS HEALTHCARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2010
-----------------------------------------------------
Last Update Date | 05/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2333-2341 W. 95TH ST , BLDG C, STE 2
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60643-1003
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 312-663-4647
-----------------------------------------------------
Fax | 312-663-4737
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 WARRENVILLE RD STE 800801
-----------------------------------------------------
City | LISLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60532-1396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-296-3400
-----------------------------------------------------
Fax | 630-487-2713
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EVP, CHIEF STRATEGY OFFICER
-----------------------------------------------------
Name | MR. DARBY ANDERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-296-3443
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------