Provider Demographics
NPI:1114525243
Name:IHCC HOSPICE INC
Entity Type:Organization
Organization Name:IHCC HOSPICE INC
Other - Org Name:IN-HOME CARE CONNECTION HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-872-7447
Mailing Address - Street 1:PO BOX 57
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IL
Mailing Address - Zip Code:61356-0057
Mailing Address - Country:US
Mailing Address - Phone:815-872-7447
Mailing Address - Fax:855-356-4048
Practice Address - Street 1:680 W PERU ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IL
Practice Address - Zip Code:61356-6803
Practice Address - Country:US
Practice Address - Phone:815-872-7447
Practice Address - Fax:855-356-4048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2003200OtherILLINOIS DEPARTMENT OF PUBLIC HEALTH