Provider Demographics
NPI:1417067521
Name:LIFECARE HOME HEALTH SERVICES INC
Entity Type:Organization
Organization Name:LIFECARE HOME HEALTH SERVICES INC
Other - Org Name:LIFECARE HOME HEALTH SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADIHA
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-205-4444
Mailing Address - Street 1:3100 DUNDEE RD STE 703
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2442
Mailing Address - Country:US
Mailing Address - Phone:847-205-4444
Mailing Address - Fax:847-205-4445
Practice Address - Street 1:3100 DUNDEE RD STE 703
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2442
Practice Address - Country:US
Practice Address - Phone:847-205-4444
Practice Address - Fax:847-205-4445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010562251E00000X
IL3000484253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010562OtherDEPT OF PUBLIC HEALTH
IL4D1047761OtherCENTERS FOR MEDICARE & ME
IL147889OtherMEDICARE PROVIDER
IL50479OtherBLUE CROSS BLUE SHIELD
IL4D1047761OtherCENTERS FOR MEDICARE & ME
IL50479OtherBLUE CROSS BLUE SHIELD