Provider Demographics
NPI:1437506730
Name:HOME INSTEAD SENIOR CARE
Entity Type:Organization
Organization Name:HOME INSTEAD SENIOR CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WIENEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-784-4024
Mailing Address - Street 1:4736 N MARINE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5120
Mailing Address - Country:US
Mailing Address - Phone:773-784-4024
Mailing Address - Fax:773-334-9867
Practice Address - Street 1:4736 N MARINE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5120
Practice Address - Country:US
Practice Address - Phone:773-784-4024
Practice Address - Fax:773-334-9867
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEPHENSON & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2313595251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health