Provider Demographics
NPI:1053655357
Name:MA-DEAR HOME SERVICES, INC.
Entity Type:Organization
Organization Name:MA-DEAR HOME SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENEE'
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISSETTE-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-480-8553
Mailing Address - Street 1:1525 E 53RD ST
Mailing Address - Street 2:SUITE#1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4557
Mailing Address - Country:US
Mailing Address - Phone:312-480-8553
Mailing Address - Fax:773-667-9186
Practice Address - Street 1:1525 E 53RD ST
Practice Address - Street 2:SUITE#1000
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4557
Practice Address - Country:US
Practice Address - Phone:312-480-8553
Practice Address - Fax:773-667-9186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000215251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health