Provider Demographics
NPI:1346385481
Name:BENCHMARK HEALTH CORP
Entity Type:Organization
Organization Name:BENCHMARK HEALTH CORP
Other - Org Name:BENCHMARK HOME HEALTH CARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:MAJADUCON
Authorized Official - Last Name:AGPASA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-467-4500
Mailing Address - Street 1:5902 N MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5420
Mailing Address - Country:US
Mailing Address - Phone:773-467-4500
Mailing Address - Fax:773-467-1144
Practice Address - Street 1:5902 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5420
Practice Address - Country:US
Practice Address - Phone:773-467-4500
Practice Address - Fax:773-467-1144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010378251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7916OtherMEDICARE ID - HOME HEALTH