Provider Demographics
NPI:1114056223
Name:NATIONAL HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:NATIONAL HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-329-9933
Mailing Address - Street 1:5811 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3017
Mailing Address - Country:US
Mailing Address - Phone:847-329-9933
Mailing Address - Fax:847-930-0375
Practice Address - Street 1:5811 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-3017
Practice Address - Country:US
Practice Address - Phone:847-329-9933
Practice Address - Fax:847-930-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000701332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5486030001Medicare NSC