Provider Demographics
NPI:1114948254
Name:HEALTHCARE PARTNERS AT HOME, LLC
Entity Type:Organization
Organization Name:HEALTHCARE PARTNERS AT HOME, LLC
Other - Org Name:SIMPLY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUBILLARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-306-5668
Mailing Address - Street 1:6316 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1204
Mailing Address - Country:US
Mailing Address - Phone:773-306-5668
Mailing Address - Fax:888-439-8416
Practice Address - Street 1:6316 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1204
Practice Address - Country:US
Practice Address - Phone:773-306-5668
Practice Address - Fax:888-439-8416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1011047OtherSTATE LICENSE