Provider Demographics
NPI:1124044276
Name:SUNSHINE HOME CARE, INC.
Entity Type:Organization
Organization Name:SUNSHINE HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GEN.MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-456-3055
Mailing Address - Street 1:5411 W ADDISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-3203
Mailing Address - Country:US
Mailing Address - Phone:708-456-3055
Mailing Address - Fax:708-456-3319
Practice Address - Street 1:5411 W ADDISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-3203
Practice Address - Country:US
Practice Address - Phone:708-456-3055
Practice Address - Fax:708-456-3319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010246251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147745Medicare Oscar/Certification