Provider Demographics
NPI:1407521008
Name:INSPIRED HOMECARE OF ILLINOIS, LLC
Entity Type:Organization
Organization Name:INSPIRED HOMECARE OF ILLINOIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:HOGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-366-8936
Mailing Address - Street 1:2100 MANCHESTER ROAD
Mailing Address - Street 2:SUITE 1640, BUILDING C
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187
Mailing Address - Country:US
Mailing Address - Phone:630-963-7824
Mailing Address - Fax:630-964-8318
Practice Address - Street 1:2100 MANCHESTER ROAD
Practice Address - Street 2:SUITE 1640, BUILDING C
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187
Practice Address - Country:US
Practice Address - Phone:630-963-7824
Practice Address - Fax:630-964-8318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health