Provider Demographics
NPI:1083717953
Name:CRESCENT HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:CRESCENT HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ZULFIQAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZULFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-427-1220
Mailing Address - Street 1:6160 N. CICERO AVE.
Mailing Address - Street 2:SUITE 232
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4336
Mailing Address - Country:US
Mailing Address - Phone:773-427-1220
Mailing Address - Fax:
Practice Address - Street 1:6160 N CICERO AVE
Practice Address - Street 2:SUITE 232
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4312
Practice Address - Country:US
Practice Address - Phone:773-427-1220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010484251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010484OtherIDPH LICENSE