Provider Demographics
NPI:1215180435
Name:SHUREE HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:SHUREE HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:YOCOR
Authorized Official - Last Name:SOLAMILLO
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:773-283-4950
Mailing Address - Street 1:4492 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2515
Mailing Address - Country:US
Mailing Address - Phone:773-283-4950
Mailing Address - Fax:773-283-4980
Practice Address - Street 1:4492 WEST LAWRENCE AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-2515
Practice Address - Country:US
Practice Address - Phone:773-283-4950
Practice Address - Fax:773-283-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-31
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010956251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health