Provider Demographics
NPI:1376590521
Name:MIDWESTERN HEALTHCARE LTD.
Entity Type:Organization
Organization Name:MIDWESTERN HEALTHCARE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AUGUSTUS LEO
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-205-3467
Mailing Address - Street 1:122 W SAINT CHARLES RD
Mailing Address - Street 2:SUITE 4-B
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-2477
Mailing Address - Country:US
Mailing Address - Phone:630-617-0012
Mailing Address - Fax:630-617-0023
Practice Address - Street 1:122 W SAINT CHARLES RD
Practice Address - Street 2:SUITE 4-B
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2477
Practice Address - Country:US
Practice Address - Phone:630-617-0012
Practice Address - Fax:630-617-0023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010551251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health