Provider Demographics
NPI:1043266083
Name:ACCUCARE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:ACCUCARE HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:BSBA
Authorized Official - Phone:630-963-8862
Mailing Address - Street 1:1027 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1341
Mailing Address - Country:US
Mailing Address - Phone:630-963-8862
Mailing Address - Fax:630-963-8892
Practice Address - Street 1:1027 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1341
Practice Address - Country:US
Practice Address - Phone:630-963-8862
Practice Address - Fax:630-963-8892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL1010565251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL101565OtherH H SERVICE PROVIDER
ILIL101565OtherH H SERVICE PROVIDER