Provider Demographics
NPI:1114906047
Name:FIRST HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:FIRST HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYANN
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:SLAMA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN MS
Authorized Official - Phone:708-535-8609
Mailing Address - Street 1:14730 KILBOURNE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-3282
Mailing Address - Country:US
Mailing Address - Phone:708-535-8609
Mailing Address - Fax:708-535-8749
Practice Address - Street 1:14730 KILBOURNE AVE
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:IL
Practice Address - Zip Code:60445-3282
Practice Address - Country:US
Practice Address - Phone:708-535-8609
Practice Address - Fax:708-535-8749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010437251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010437OtherSTATE LICENSE
147833Medicare ID - Type Unspecified