Provider Demographics
NPI:1295866754
Name:4EVER CARE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:4EVER CARE HOME HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESITA
Authorized Official - Middle Name:MALINAO
Authorized Official - Last Name:JOVELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:847-357-8008
Mailing Address - Street 1:2015 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:STE 102
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4150
Mailing Address - Country:US
Mailing Address - Phone:847-357-8008
Mailing Address - Fax:847-357-8118
Practice Address - Street 1:2015 S ARLINGTON HEIGHTS RD
Practice Address - Street 2:STE 102
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4150
Practice Address - Country:US
Practice Address - Phone:847-357-8008
Practice Address - Fax:847-357-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010474251E00000X
IL1011868251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7963Medicare ID - Type UnspecifiedPROVIDER NUMBER