Provider Demographics
NPI:1043922586
Name:MD PARKER HOME SERVICES LLC
Entity Type:Organization
Organization Name:MD PARKER HOME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-352-8615
Mailing Address - Street 1:405 SHAWMUT AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60526-2000
Mailing Address - Country:US
Mailing Address - Phone:708-352-8615
Mailing Address - Fax:708-354-9620
Practice Address - Street 1:405 SHAWMUT AVE STE 210
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60526-2000
Practice Address - Country:US
Practice Address - Phone:708-352-8615
Practice Address - Fax:708-354-9620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care