1497903108 NPI number — ADDUS HEALTHCARE INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497903108 NPI number — ADDUS HEALTHCARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADDUS HEALTHCARE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497903108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 WARRENVILLE RD STE 800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LISLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60532-0912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-296-3400
Provider Business Mailing Address Fax Number:
630-487-2713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
142 GLYNBROOK ST N
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
KEIZER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97303-5989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-364-6443
Provider Business Practice Location Address Fax Number:
855-893-0654
Provider Enumeration Date:
09/05/2008

Additional Information

Authorized Official

Authorized Official Last Name:
ANDERSON
Authorized Official First Name:
DARBY
Authorized Official Middle Name:
Authorized Official Title or Position:
EVP, CHIEF STRATEGY OFFICER
Authorized Official Telephone Number:
630-296-3443

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  152028 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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