Provider Demographics
NPI:1003858002
Name:PROFICIENT HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:PROFICIENT HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:UL
Authorized Official - Last Name:HAQ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:847-213-0604
Mailing Address - Street 1:8142 LAWNDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3322
Mailing Address - Country:US
Mailing Address - Phone:847-213-0604
Mailing Address - Fax:847-213-0432
Practice Address - Street 1:8142 LAWNDALE AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-3322
Practice Address - Country:US
Practice Address - Phone:847-213-0604
Practice Address - Fax:847-213-0432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010455251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7905Medicare ID - Type Unspecified