Provider Demographics
NPI:1326152067
Name:WESTERN ILLINOIS MANAGED HOME SERVICES, INC.
Entity Type:Organization
Organization Name:WESTERN ILLINOIS MANAGED HOME SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-342-3516
Mailing Address - Street 1:1197 N HENDERSON ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-2574
Mailing Address - Country:US
Mailing Address - Phone:309-342-3516
Mailing Address - Fax:309-342-2312
Practice Address - Street 1:1197 N HENDERSON ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-2574
Practice Address - Country:US
Practice Address - Phone:309-342-3516
Practice Address - Fax:309-342-2312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2006-N0395251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care