Provider Demographics
NPI:1407886856
Name:EXPRESS PROFESSIONALS HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:EXPRESS PROFESSIONALS HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TESSALEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-974-6585
Mailing Address - Street 1:900 JORIE BLVD STE 85
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2253
Mailing Address - Country:US
Mailing Address - Phone:630-974-6585
Mailing Address - Fax:630-974-5776
Practice Address - Street 1:900 JORIE BLVD STE 85
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2253
Practice Address - Country:US
Practice Address - Phone:630-974-6585
Practice Address - Fax:630-974-5776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011623251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147868Medicare Oscar/Certification