Provider Demographics
NPI:1396861159
Name:OPTIMUM PROFESSIONALS HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:OPTIMUM PROFESSIONALS HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOIDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAYA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:773-847-3220
Mailing Address - Street 1:3520 S MORGAN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1524
Mailing Address - Country:US
Mailing Address - Phone:773-847-3220
Mailing Address - Fax:773-847-3828
Practice Address - Street 1:3520 S MORGAN ST.
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-5655
Practice Address - Country:US
Practice Address - Phone:773-847-3220
Practice Address - Fax:773-847-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health