Provider Demographics
NPI:1275748113
Name:ILLINOIS INFUSION AND HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:ILLINOIS INFUSION AND HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUARESMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-612-5780
Mailing Address - Street 1:1300 BASSWOOD RD
Mailing Address - Street 2:SUITE 200 M&N
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4522
Mailing Address - Country:US
Mailing Address - Phone:847-604-0140
Mailing Address - Fax:847-241-0260
Practice Address - Street 1:1300 BASSWOOD RD
Practice Address - Street 2:SUITE 200 M&N
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4522
Practice Address - Country:US
Practice Address - Phone:847-604-0140
Practice Address - Fax:847-241-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010435251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147948Medicare ID - Type Unspecified