1851439079 NPI number — UNITED HOME CARE INCORPORATED OF ILLINOIS

Table of content: (NPI 1851439079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851439079 NPI number — UNITED HOME CARE INCORPORATED OF ILLINOIS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED HOME CARE INCORPORATED OF ILLINOIS
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:
1851439079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 E HIGGINS ROAD
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
ELK GROVE VILLAGE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60007-1437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-640-2030
Provider Business Mailing Address Fax Number:
847-640-2031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 E HIGGINS ROAD
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
ELK GROVE VILLAGE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60007-1437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-640-2030
Provider Business Practice Location Address Fax Number:
847-640-2031
Provider Enumeration Date:
02/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AGNO
Authorized Official First Name:
JUDY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRES./ADMINISTRATOR
Authorized Official Telephone Number:
847-640-2030

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 1010181 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 14D0998502 . This is a "CLIA" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com