Provider Demographics
NPI:1003095159
Name:SUPERB HOME HEALTH, INC.
Entity Type:Organization
Organization Name:SUPERB HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOBENCIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-803-8873
Mailing Address - Street 1:3158 DES PLAINES AVE
Mailing Address - Street 2:STE 30
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4220
Mailing Address - Country:US
Mailing Address - Phone:847-803-8873
Mailing Address - Fax:847-803-8846
Practice Address - Street 1:3158 DES PLAINES AVE
Practice Address - Street 2:STE 30
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-4220
Practice Address - Country:US
Practice Address - Phone:847-803-8873
Practice Address - Fax:847-803-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health