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NPI Code Detail

MEDICARE: DOMINION HOME HEALTH CARE INC.

MEDICARE: DOMINION HOME HEALTH CARE INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyIL
2251E00000XHome Health Agency1011216IL

General Provider Information

NPI Number : 1295062404
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOMINION HOME HEALTH CARE INC.
Provider Business Mailing Address
First Line : 3434 RIDGE RD
Second Line :
City : LANSING
State : IL
Zip : 60438-3102
Country : US
Telephone Number : 708-858-6132
Fax Number : 708-858-6156
Provider Business Practice Location Address
First Line : 3434 RIDGE RD
Second Line :
City : LANSING
State : IL
Zip : 60438-3102
Country : US
Telephone Number : 708-858-6132
Fax Number : 708-858-6156
Authorized Official
Title or Position : ADMINISTATOR
Name : VICTOR OKEZIE IKE
Credential :
Telephone Number : 708-527-0808
Provider Enumeration Date : 11/09/2009
Last Update Date : 11/11/2024

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Directions to “DOMINION HOME HEALTH CARE INC. ” Practice Location

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