Provider Demographics
NPI:1407267842
Name:HOME CARE PERSONAL SERVICES, INC.
Entity Type:Organization
Organization Name:HOME CARE PERSONAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HENRIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-434-0071
Mailing Address - Street 1:1809 N MILL ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1288
Mailing Address - Country:US
Mailing Address - Phone:630-434-0071
Mailing Address - Fax:630-434-0073
Practice Address - Street 1:820 E TERRA COTTA AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3649
Practice Address - Country:US
Practice Address - Phone:815-455-7005
Practice Address - Fax:815-455-7030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE PERSONAL SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL300154251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL300154OtherIDPH LICENSE