Provider Demographics
NPI:1346431251
Name:HOMEHEALTH OF AMERICA, INC.
Entity Type:Organization
Organization Name:HOMEHEALTH OF AMERICA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:TAMONDONG
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-588-3004
Mailing Address - Street 1:5940 W. TOUHY AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714
Mailing Address - Country:US
Mailing Address - Phone:847-588-3004
Mailing Address - Fax:847-588-3203
Practice Address - Street 1:5940 W. TOUHY AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714
Practice Address - Country:US
Practice Address - Phone:847-588-3004
Practice Address - Fax:847-588-3203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010759251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
148107Medicare Oscar/Certification