Provider Demographics
NPI:1033445283
Name:NE HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:NE HEALTHCARE SERVICES, INC
Other - Org Name:GREATER CHICAGO HOME HEALTH LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONETTE
Authorized Official - Middle Name:T
Authorized Official - Last Name:TAFALLA
Authorized Official - Suffix:
Authorized Official - Credentials:AA, BSBA
Authorized Official - Phone:773-292-8891
Mailing Address - Street 1:1029 N SACRAMENTO AVE
Mailing Address - Street 2:1ST FL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2746
Mailing Address - Country:US
Mailing Address - Phone:777-329-2889
Mailing Address - Fax:773-252-3060
Practice Address - Street 1:1029 N SACRAMENTO AVE
Practice Address - Street 2:1ST FL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2746
Practice Address - Country:US
Practice Address - Phone:777-329-2889
Practice Address - Fax:773-252-3060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010718251E00000X
IL1011788251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D1072972OtherCLIA
14-8230Medicare PIN